SRS69 - Transitioning to da vinci xi for colorectal cancer surgery: a prospective cohort study of 102 cases from a UK centre with a structured robotic programme

Abstract Introduction This study assessed short-term outcomes and learning curves following the introduction of the Intuitive© da Vinci Xi robotic platform for elective colorectal cancer resections at West Hertfordshire Teaching Hospital NHS Trust (WHTH). This transition was supported by prior experience with CMR Surgical© Versius. Outcomes were benchmarked against national data. Methods A prospective cohort included all elective colorectal resections between April 2024 and March 2025. Collected data included demographics, diagnoses, operative details, complications, length-of-stay (LOS), and oncological outcomes. Results were compared with historical laparoscopic data from the National Bowel Cancer Audit (NBOCA, 2019–2022) and Model Health System (MHS, 2024). Learning curves for operative time in right hemicolectomy (RH), anterior resection, and abdominoperineal resection were assessed using cumulative sum (CUSUM) analysis. Results The study included 102 patients (median age 69; 54.9% male). All colonic resections (n = 72) achieved lymph node yields ≥12, higher than NBOCA’s 88.1% (P = 0.001). Negative margins in rectal resections (n = 30) were 96.7 versus 90.1% in NBOCA (P = 0.10). Conversion to open surgery was 3%, with 1% anastomotic leak and 4% return to theatre. MHS data showed 13% of WHTH patients had LOS ≥9 days versus 29% nationally (P = 0.0001); dropping to 7.1% in our robotic cohort. CUSUM analysis showed learning curve stabilisation after ∼12 RH and 20 pelvic resections, with faster proficiency in surgeons with prior robotic experience. Conclusions The da Vinci Xi platform’s introduction, supported by prior Versius use, achieved excellent oncological outcomes, reduced LOS, and low complications—highlighting the value of structured robotic integration in NHS colorectal care.