Ramie Surgical Outcomes Using the Novel Surgical Robot Hinotori—comparison With Davinci Ramie

Background In robot-assisted minimally invasive esophagectomy(RAMIE), its precision and stable 3D images are especially useful for performing recurrent nerve lymph node dissection. As the number of cases increases in the future, which model will be newly selected is an important issue. In our department, following the introduction of the daVinci Xi (daRAMIE) in 2021, we introduced the Hinotori in September 2023 (hiRAMIE). By December 2024, a total of 102 cases (58 daVinci Xi cases and 44 hinotori cases) had been experienced. In this study, to clarify the efficacy of hiRAMIE, we compared the surgical results with those of daRAMIE. Methods Group H patients were classified into 39 patients who underwent hiRAMIE and group D patients who underwent daRAMIE (pharyngolaryngectomy and cases with complications of other organs were excluded). The patients were compared after adjusting background factors for age, gender, fStage≥3, and surgeon (percentage of surgeons who were certified endoscopists and esophageal surgeons (hereafter referred to as ‘supervisors’)) using propensity score matching. Results After matching, there were 27 patients in both groups. Age H/D: 69/69 years, male ratio H/D: 0.82/0.85, supervising surgeon ratio H/D: 0.44/0.52, fStage≥3 H/D: 0.41/0.44, NAC performed ratio H/D: 0.52/0.6. Console time was H/D: 227/212 minutes, operative time H/D: 58902/595 minutes, and blood loss H/D: 105/112 mL. Short-term outcomes were Clavien-Dindo≥3 H/D: 0.15/0.30, recurrent nerve palsy (CD ≥ 2) H/D: 0.07/0.11, suture failure H/D: 0.11/0.07, and postoperative hospital stay H/D: 18/23 days. There were no significant differences in any of the parameters examined (all median values). Conclusion There is no difference in surgical and short-term postoperative outcomes between hiRAMIE and daRAMIE, and they can be useful options for RAMIE.