A comparison between the da Vinci Xi EndoWrist Stapler and a conventional laparoscopic stapler in rectal transection: A randomized controlled trial

Distal rectal transection following robotic total mesorectal excision for rectal cancer is challenging. This can be performed with either a robotic stapler (RS) or laparoscopic stapler (LS). We compared the operative outcomes and ergonomic differences between RS and LS.Forty patients with rectal cancer who were planned for robotic rectal surgery were randomized to either RS or LS.The mean number of stapler cartridges expended was similar between RS and LS (1.75 vs. 2.05, p = 0.082). Significantly less stapler adjustments were required in the RS group (1.55 vs. 2.75, p = 0.014). Results from the user experience survey showed that RS scored better.The RS required less adjustments and resulted in a better user experience. While this complemented the use of robotics in rectal surgery, it did not result in a significant reduction in the number of stapler cartridges required for rectal transection.