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Robot-assisted radical resection of colorectal cancer using the KangDuo surgical robot versus the da Vinci ** robotic system: short-term outcomes of a multicentre randomised controlled noninferiority trial

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Abstract

Background

The KangDuo surgical robot (KD-SR-01) was recently developed in China. This study aims to evaluate the short-term outcomes of KD-SR-01 for colorectal cancer surgery.

Methods

This is a multicentre randomised controlled noninferiority trial conducted in three centers in China. Enrolled patients were randomly assigned at a 1:1 ratio to receive surgery using the KD-SR-01 system (KD group) or the da Vinci ** (DV) robotic system (DV group). The primary endpoint was the success rate of operation. The second endpoints were surgical outcomes, pathological outcomes, and postoperative outcomes.

Results

Between July 2022 and May 2023. A total of 100 patients were included in the trial and randomly assigned to the KD group (50 patients) and the DV group (50 patients). All cases were completed successfully without conversion to laparoscopic surgery. The time to flatus and the incidence of postoperative complications of Clavien-Dindo grade II or higher grade were comparable between the two groups. Surgeons reported a high level of comfort with the KD-SR-01 system. In the subgroup analysis of different operative procedures, there were no significant differences in docking time, console time, blood loss, and the length of the incision for extraction between the two groups. There were no differences in pathological outcomes including maximum tumor diameter, circumferential resection margin, distal resection margin, and number of harvested lymph nodes.

Conclusions

The KD-SR-01 system was a viable option for colorectal cancer robotic surgery, with acceptable short-term outcomes comparable to the da Vinci ** robotic system.

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References

  1. Zheng R, Zhang S, Zeng H, Wang S, Sun K, Chen R, Li L, Wei W, He J (2022) Cancer incidence and mortality in China, 2016. J Natl Cancer Center 2:1–9. https://doi.org/10.1016/j.jncc.2022.02.002

    Article  Google Scholar 

  2. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52

    Article  PubMed  Google Scholar 

  3. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, C.O.c.L.o.O.R.S. Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    Article  PubMed  Google Scholar 

  4. Jiang WZ, Xu JM, **ng JD, Qiu HZ, Wang ZQ, Kang L, Deng HJ, Chen WP, Zhang QT, Du XH, Yang CK, Guo YC, Zhong M, Ye K, You J, Xu DB, Li XX, **ong ZG, Tao KX, Ding KF, Zang WD, Feng Y, Pan ZZ, Wu AW, Huang F, Huang Y, Wei Y, Su XQ, Chi P, L.t. Investigators (2022) Short-term outcomes of laparoscopy-assisted vs open surgery for patients with low rectal cancer: The LASRE Randomized Clinical Trial. JAMA Oncol 8:1607–1615. https://doi.org/10.1001/jamaoncol.2022.4079.2022/09/16

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES, Lacy AM, Bemelman WA, Andersson J, Angenete E, Rosenberg J, Fuerst A, Haglind E, C.I.S. Group (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372:1324–1332

    Article  CAS  PubMed  Google Scholar 

  6. Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y, Zhang W, Zhao R, Zhang C, Cheng L, Zhang X, Liang F, He G, Wei Y, Xu J, R.S. Group (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7:991–1004

    Article  PubMed  Google Scholar 

  7. Mirkin KA, Kulaylat AS, Hollenbeak CS, Messaris E (2018) Robotic versus laparoscopic colectomy for stage I-III colon cancer: oncologic and long-term survival outcomes. Surg Endosc 32:2894–2901. https://doi.org/10.1007/s00464-017-5999-6.2017/12/24

    Article  PubMed  Google Scholar 

  8. Emile SH, Horesh N, Garoufalia Z, Gefen R, Zhou P, Strassman V, Wexner SD (2023) Robotic and laparoscopic colectomy: propensity score-matched outcomes from a national cancer database. Br J Surg 110:717–726. https://doi.org/10.1093/bjs/znad096.2023/04/19

    Article  PubMed  Google Scholar 

  9. Fan S, Dai X, Yang K, **ong S, **ong G, Li Z, Cheng S, Li X, Meng C, Guan H, Huang Y, Mu L, Cui L, Zhou L, Li X (2021) Robot-assisted pyeloplasty using a new robotic system, the KangDuo-Surgical Robot-01: a prospective, single-centre, single-arm clinical study. BJU Int 128:162–165. https://doi.org/10.1111/bju.15396.2021/03/17

    Article  PubMed  Google Scholar 

  10. Fan S, Zhang Z, Wang J, **ong S, Dai X, Chen X, Li Z, Han G, Zhu J, Hao H, Yu W, Cui L, Shen C, Li X, Zhou L (2022) Robot-assisted radical prostatectomy using the KangDuo Surgical Robot-01 system: a prospective, single-center, single-arm clinical study. J Urol 208(1):119–127

    Article  PubMed  Google Scholar 

  11. Li X, Xu W, Fan S, **ong S, Dong J, Wang J, Dai X, Yang K, **e Y, Liu G, Meng C, Zhang Z, Cai L, Zhang C, Zhang Z, Ji Z, Shen C, Zhou L (2023) Robot-assisted partial nephrectomy with the newly developed KangDuo surgical robot versus the da Vinci Si surgical system: a double-center prospective randomized controlled noninferiority trial. Eur Urol Focus 9:133–140. https://doi.org/10.1016/j.euf.2022.07.008.2022/11/30

    Article  CAS  PubMed  Google Scholar 

  12. Dong J, Ji R, Liu G, Zhou J, Wang H, Xu W, Ji Z, Cui L (2023) Feasibility, safety and effectiveness of robot-assisted retroperitoneal partial adrenalectomy with a new robotic surgical system: a prospective clinical study. Front Surg 10:1071321. https://doi.org/10.3389/fsurg.2023.1071321.2023/03/14

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae.2004/07/27

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hart SG, Staveland LE (1988) Development of NASA-TLX (Task Load Index): results of empirical and theoretical research. Adv Psychol 52:139–183

    Article  Google Scholar 

  15. Sun Z, Hou W, Liu W, Liu J, Li K, Wu B, Lin G, Xue H, Pan J, **ao Y (2023) Establishment of surgical difficulty grading system and application of MRI-based artificial intelligence to stratify difficulty in laparoscopic rectal surgery. Bioengineering (Basel) 10:468

    Article  PubMed  Google Scholar 

  16. Yao Q, Sun QN, Zhou JJ, Ma Y, Ren J, Wang LH, Wang DR (2023) Robotic-assisted intracorporeal versus extracorporeal techniques in sigmoidectomy: a propensity score-matched analysis. J Robot Surg 17:2479

    Article  PubMed  Google Scholar 

  17. Cuk P, Kjær MD, Mogensen CB, Nielsen MF, Pedersen AK, Ellebæk MB (2022) Short-term outcomes in robot-assisted compared to laparoscopic colon cancer resections: a systematic review and meta-analysis. Surg Endosc 36:32–46. https://doi.org/10.1007/s00464-021-08782-7

    Article  PubMed  Google Scholar 

  18. Dohrn N, Yikilmaz H, Laursen M, Khesrawi F, Clausen FB, Sorensen F, Jakobsen HL, Brisling S, Lykke J, Eriksen JR, Klein MF, Gogenur I (2022) Intracorporeal versus extracorporeal anastomosis in robotic right colectomy: a multicenter, triple-blind. Randomized Clin Trial Ann Surg 276:e294–e301. https://doi.org/10.1097/SLA.0000000000005254.2022/02/08

    Article  Google Scholar 

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Funding

This study was funded by National Key R&D Program of China (2023YFC2413400).

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Author notes

  1. Zhen Sun, Tianyi Ma and Zhen Huang have contributed equally to this work.

Authors and Affiliations

  1. Division of Colorectal Surgery, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Bei**g, 100730, China

    Zhen Sun, Junyang Lu, Lai Xu & Yi **ao

  2. Department of Colorectal Cancer Surgery, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, 150086, Heilongjiang, China

    Tianyi Ma, Yuliuming Wang & Guiyu Wang

  3. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China

    Zhen Huang, **angshu Li & Zhengqiang Wei

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  1. Zhen Sun
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Corresponding authors

Correspondence to Zhengqiang Wei, Guiyu Wang or Yi **ao.

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Disclosures

Zhen Sun, Tianyi Ma, Zhen Huang, Junyang Lu, Lai Xu, Yuliuming Wang, **angshu Li, Zhengqiang Wei, Guiyu Wang and Yi **ao have no conflicts of interest or financial ties to disclose.

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Sun, Z., Ma, T., Huang, Z. et al. Robot-assisted radical resection of colorectal cancer using the KangDuo surgical robot versus the da Vinci ** robotic system: short-term outcomes of a multicentre randomised controlled noninferiority trial. Surg Endosc 38, 1867–1876 (2024). https://doi.org/10.1007/s00464-024-10682-5

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