Comparison of Surgical Outcomes of da Vinci Surgical Systems X and Xi: A Single-center Study

Abstract Background: The da Vinci surgical systems (X and Xi) are fourth-generation systems marketed by Intuitive Inc. The X system is less expensive compared with the Xi system. This study compared the surgical outcomes of patients who underwent hysterectomy using the X and Xi systems. Methods: Data of 172 patients who underwent robot-assisted total hysterectomies by four surgeons between April 2019 and March 2023 were retrospectively analyzed in a single-center study. The patients were divided into two groups based on the system used for the surgery. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt-out consent in accordance with institutional guidelines. Results: The operative and console times in group X were shorter than those in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, pre-operative diagnosis, and surgical approach. No statistical differences were observed in a subgroup analysis of patients who underwent robot-assisted total laparoscopic hysterectomy without lymphadenectomy. Conclusion: Perioperative outcomes for the X and Xi da Vinci surgical systems were equivalent. The cost-effective X system may allow the widespread use of robotic surgeries.