A comparison between the da Vinci Xi EndoWrist Stapler and a conventional laparoscopic stapler in rectal transection: A randomized controlled trial

Abstract

BACKGROUND: Distal rectal transection following robotic total mesorectal excision for rectal cancer is challenging. This can be performed with either a robotic stapler (RS) or laparoscopic stapler (LS). We compared the operative outcomes and ergonomic differences between RS and LS. METHODS: Forty patients with rectal cancer who were planned for robotic rectal surgery were randomized to either RS or LS. RESULTS: The mean number of stapler cartridges expended was similar between RS and LS (1.75 vs. 2.05, p = 0.082). Significantly less stapler adjustments were required in the RS group (1.55 vs. 2.75, p = 0.014). Results from the user experience survey showed that RS scored better. CONCLUSION: The RS required less adjustments and resulted in a better user experience. While this complemented the use of robotics in rectal surgery, it did not result in a significant reduction in the number of stapler cartridges required for rectal transection.