Comparison of short- and mid-term outcomes between the Senhance digital laparoscopic system and laparoscopic colectomy: a propensity score matching study

Background: The Senhance digital laparoscopic system (Senhance) is a surgical robot approved for use in Japan after the da Vinci system. Our institution was the first to introduce this system, which has been used primarily for gastrointestinal surgery. Featuring tactile feedback, eye-movement-controlled camera operation, stereoscopic vision, and magnification, the short-term postoperative outcomes of the Senhance in abdominal surgery have been documented. This study aimed to evaluate the safety and feasibility of Senhance by examining mid-term postoperative outcomes.

Methods: Between January 2018 and December 2020, 743 patients underwent colorectal cancer colectomy at our institution. We compared 50 cases of Senhance-assisted colectomy with 430 laparoscopic colectomy cases using 1:1 propensity score matching, adjusting for covariates such as sex, age, tumor location, BMI, ASA-PS, cT, and cN. Short- and mid-term surgical outcomes were compared between the Senhance (S) and laparoscopic (L) groups.

Results: After matching, 47 patients were included in each group. There were no significant differences in the patient backgrounds. The operative time was significantly longer in the S group compared to the L group (median: 240 [101-378] minutes vs. 191 [100-370] minutes, p < 0.01). No significant differences were observed in postoperative complications of Clavien-Dindo grade 2 or higher within 30 days post-surgery, and no robot-related adverse events were reported. The 3-year disease-free survival rates were 88.7% in the S group and 77.1% in the L group (p = 0.178; HR, 1.423; 95% CI 0.916-2.211). The overall survival rate was 97.7% in both groups (p = 0.897; HR, 1.202; 95% CI 0.075-19.26).

Conclusion: Senhance-assisted colectomy is safe with mid-term outcomes comparable to laparoscopic surgery. However, the extended operation time remains challenging, necessitating further studies, including randomized controlled trials and multicenter studies, to validate these findings.