Comparative outcomes of da Vinci SP versus da Vinci Xi platforms in robotic cholecystectomy: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: p = 0.0049

• Effect Size: Mean difference -2.41 minutes favouring DV-SP

• Primary Outcome: Operative time significantly reduced with DV-SP

• Nnt Or Sensitivity: Console time also reduced by 7.24 minutes (95% CI -9.77 to -4.72, p < 0.0001)

• Confidence Interval: 95% CI -4.09 to -0.73 minutes

Clinical Application

Limited by availability of DV-SP technology and surgeon training requirements Relevant to major Australian hospitals with robotic surgery programs; cost-effectiveness considerations important given PBS funding constraints for robotic procedures Patients suitable for robotic cholecystectomy in centres with both DV-SP and DV-Xi platforms

Abstract

As robotic cholecystectomy adoption accelerates, the evidence comparing the perioperative outcomes of the Da Vinci Xi (DV-Xi) multiport platform to the Da Vinci Single-Port (DV-Sp) platform remains scarce. This meta-analysis provides the first systematic comparison of perioperative outcomes between these platforms. To compare perioperative safety and operative efficiency outcomes between the DV-Sp and the DV-Xi systems performing cholecystectomy. We thoroughly searched PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov from inception till December 22, 2025. The key outcomes of interest included mean operative time, console time, docking time, pain scores on the day of the operation, pain scores after 24 h, estimated blood loss, and length of hospital stay. We conducted random-effects meta-analysis and leave-one-out sensitivity analysis using RStudio v 4.5.2. The ROBINS-I was used for the risk of bias assessment. A GRADE assessment through GRADEpro was performed. Four observational studies comprising 833 patients (DV-Sp: n = 416; DV-Xi: n = 417) met the set inclusion criteria, and no RCTs were found. The DV-Sp showed significantly decreased mean operative time (MD = -2.41 min; 95% CI - 4.09 to - 0.73, p = 0.0049) and console time (MD = - 7.24; 95% CI - 9.77 to - 4.72, P < 0.0001) with no heterogeneity (I² = 0%). Two studies reported reduced pain scores in the DV-SP group. There was no significant difference found in the pooled estimates of post-operative pain scores, blood loss, docking time, and length of hospital stay between the two platforms. The DV-Sp demonstrated modest but consistent reductions in operative and console time with comparable safety to the DV-Xi system. Pain scores on the day of surgery and after 24 h of operation were reported low in the DV-SP group. While the magnitude of time differences is unlikely to impact individual patient outcomes, cumulative reductions across high-volume operating centers may translate into meaningful gains in operating room efficiency. However, substantial heterogeneity, particularly in pain-related outcomes and docking time, warrants cautious interpretation of these outcomes.

References

1. 1.Amin, F., Ishfaq, A., Ullah, F., Aaquib, Z., Zafar, Z., Abid, A., Rehman, T., Ahmed, A. B., & Khan, W. A. (2026). Comparative outcomes of da Vinci SP versus da Vinci Xi platforms in robotic cholecystectomy: a systematic review and meta-analysis. Journal of Robotic Surgery. https://doi.org/10.3389/fpubh.2025.1614654