P1.181. Comparison of the Da Vinci DV5 System With Force Feedback and the Xi Platform in Robotic Transthoracic Esophagectomy

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background The da Vinci DV5 system incorporates integrated force feedback to enhance tissue handling and precision. By providing real-time tactile information, force feedback may reduce excessive traction and potentially minimize tissue injury. However, its clinical impact in robotic transthoracic esophagectomy remains unclear. We compared perioperative outcomes between the da Vinci Xi and DV5 platforms. Methods This retrospective study included consecutive patients undergoing robotic transthoracic esophagectomy with cervical esophago-gastrostomy between December 2024 and February 2026, performed by a single high-volume surgeon (>300 prior cases). Patients treated with the Xi platform (n=102) were compared with those undergoing DV5 with force feedback (n=21). Baseline demographics, clinical stage, and neoadjuvant therapy were evaluated. Outcomes included overall 30-day complications, major complications (Clavien–Dindo ≥III), pulmonary complications, anastomotic leakage, vocal cord palsy, reoperation, readmission, operative time, console time, and blood loss. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results Baseline characteristics were comparable between groups. The DV5 group had a lower rate of overall 30-day complications than the Xi group (52.8% vs. 76.4%; OR 0.34, 95% CI 0.13–0.89; p=0.025). Major complications were less frequent with DV5 (19.1% vs. 35.3%), without statistical significance (p=0.148). Vocal cord palsy occurred less often in the DV5 group (14.3% vs. 29.4%, p=0.154). Rates of pulmonary complications, anastomotic leakage, reoperation, and readmission were similar. Operative and console times tended to be shorter with DV5, without statistical significance, and estimated blood loss was comparable. In multivariable logistic regression adjusting for age, neoadjuvant therapy, tumor location, and clinical stage, DV5 use remained independently associated with reduced 30-day complications (adjusted OR 0.34, 95% CI 0.13–0.93; p=0.035). Conclusion Use of the DV5 system with force feedback was associated with a lower overall complication rate with a possible tendency toward shorter operation time. Although limited by retrospective design and small sample size, these findings suggest that force feedback technology may contribute to optimizing perioperative outcomes in robotic esophagectomy.