Abstract: Objective To investigate the safety and feasibility of Da Vinci Xi robotic surgical system in full robotic radical distal gastrectomy. Methods The clinical data of patients treated with Da Vinci robotic surgical system in full radical distal gastrectomy by Jiang Zhiweis team during Oct. 2017 and Feb. 2020 were retrospectively analyzed. Lymph node dissection and digestive tract reconstruction were performed under microscope in all patients. Radical distal gastrectomy with Da Vinci S system was performed in 63 patients(S system group), and radical distal gastrectomy with Da Vinci Xi system was performed in 39 patients(Xi system group). The operation situation, postoperative recovery and complications were recorded. Results All operations were successful, with no conversion to open surgery. There were no significant differences in intraoperative blood loss ［(69.1±43.2)mL vs(84.2±48.9)mL, P=0.091］ and number of lymph node dissection ［(31.4±8.9)vs(32.4±9.4), P=0.357］ between Xi system group and S system group. Xi system had significantly shorter machine assembly time ［(5.1±1.9)min vs(11.2±3.7)min, P<0.001］, shorter operation time ［(206.2±45.3)min vs(221.5±42.3)min, P=0.013］, and lower intraoperative lens cleaning frequency ［(4.3±1.6)times vs(12.2±4.9)times, P<0.001］ than S system. There were no significant differences in time to first off-bed activity, time to recover semiliquid diet, time to first flatus, postoperative length of stay and incidence of complications between the two groups. Conclusion The Da Vinci system is safe and feasible for radical distal gastrectomy, and can be used to perform accurate surgical manipulations such as suture and knotting. The new Da Vinci robotic Xi system has a better endoscope view of 80°, more flexible robotic arm and a suspended platform, which can significantly save surgical time.

Key words: Gastric neoplasms, Da Vinci robotic surgical system, Radical distal gastrectomy