Comparison of surgical outcomes of da Vinci surgical systems X and Xi: A single‐center study

Background The da Vinci surgical systems (X and Xi) are fourth‐generation systems marketed by Intuitive Inc. The X system is less expensive than the Xi system. This study compared the surgical outcomes of patients who underwent hysterectomy using the X and Xi systems. Methods Data from 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 surgical system used. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt‐out consent in accordance with the institutional guidelines. Results Operative time (126.6 ± 29.5 for X, 138.2 ± 38.5 for Xi, p = .227) and console time (92.9 ± 27.0 for X, 105.5 ± 34.7 for Xi, p = .089) were insignificantly shorter in group X than in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, preoperative diagnosis, and surgical approach. No significant differences between X and Xi were observed in a subgroup analysis of patients who underwent robot‐assisted total laparoscopic hysterectomy without lymphadenectomy (operative time: 199.0 ± 26.5 for X, 221.5 ± 45.1 for Xi, p = .227; console time: 162.1 ± 25.0 for X, 178.3 ± 0.314 for Xi, p = .314). 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.