Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches

(1) Minimally invasive techniques are standard in colorectal surgery, though complete mesocolic excision (CME) with central lymphadenectomy remains technically demanding. Robotic systems may address these challenges. While the DaVinci system is well established, the modular Dexter system allows rapi...

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Main Authors: Julius Pochhammer, Frederike Franke, Matthias Martin, Jan Henrik Beckmann, Daniar Osmonov, Ibrahim Alkatout, Thomas Becker
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/7/1122
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author Julius Pochhammer
Frederike Franke
Matthias Martin
Jan Henrik Beckmann
Daniar Osmonov
Ibrahim Alkatout
Thomas Becker
author_facet Julius Pochhammer
Frederike Franke
Matthias Martin
Jan Henrik Beckmann
Daniar Osmonov
Ibrahim Alkatout
Thomas Becker
author_sort Julius Pochhammer
collection DOAJ
description (1) Minimally invasive techniques are standard in colorectal surgery, though complete mesocolic excision (CME) with central lymphadenectomy remains technically demanding. Robotic systems may address these challenges. While the DaVinci system is well established, the modular Dexter system allows rapid switching between laparoscopy and robotics. (2) This prospective single-surgeon study compared right hemicolectomy with CME and intracorporeal anastomosis using Dexter, DaVinci, and conventional laparoscopy in 75 patients (25 per group) at a German high-volume center. Outcomes assessed included operative time, complications, lymph node yield, and CME quality. (3) Mean operative time was longest with DaVinci (190.5 min) versus Dexter (164.8 min) and laparoscopy (152.6 min). Intracorporeal anastomosis was more frequent in robotic groups. No significant differences were found in lymph node yield, CME quality, postoperative complications, length of stay, or survival. (4) The ability to convert briefly to laparoscopy during Dexter procedures helped manage challenging steps, especially during the learning curve. The results suggest that Dexter is a safe, feasible alternative to established robotic and laparoscopic techniques, with the added benefits of flexibility and integration into existing workflows.
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spelling doaj-art-746b7e81aa0a4a83a33984546ea512382025-08-20T03:07:58ZengMDPI AGLife2075-17292025-07-01157112210.3390/life15071122Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic ApproachesJulius Pochhammer0Frederike Franke1Matthias Martin2Jan Henrik Beckmann3Daniar Osmonov4Ibrahim Alkatout5Thomas Becker6Department of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDepartment of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDepartment of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDepartment of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDepartment of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, GermanyDepartment of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDepartment of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany(1) Minimally invasive techniques are standard in colorectal surgery, though complete mesocolic excision (CME) with central lymphadenectomy remains technically demanding. Robotic systems may address these challenges. While the DaVinci system is well established, the modular Dexter system allows rapid switching between laparoscopy and robotics. (2) This prospective single-surgeon study compared right hemicolectomy with CME and intracorporeal anastomosis using Dexter, DaVinci, and conventional laparoscopy in 75 patients (25 per group) at a German high-volume center. Outcomes assessed included operative time, complications, lymph node yield, and CME quality. (3) Mean operative time was longest with DaVinci (190.5 min) versus Dexter (164.8 min) and laparoscopy (152.6 min). Intracorporeal anastomosis was more frequent in robotic groups. No significant differences were found in lymph node yield, CME quality, postoperative complications, length of stay, or survival. (4) The ability to convert briefly to laparoscopy during Dexter procedures helped manage challenging steps, especially during the learning curve. The results suggest that Dexter is a safe, feasible alternative to established robotic and laparoscopic techniques, with the added benefits of flexibility and integration into existing workflows.https://www.mdpi.com/2075-1729/15/7/1122CMEhemicolectomycolorectal cancerrobotic surgeryminimally invasive surgery
spellingShingle Julius Pochhammer
Frederike Franke
Matthias Martin
Jan Henrik Beckmann
Daniar Osmonov
Ibrahim Alkatout
Thomas Becker
Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
Life
CME
hemicolectomy
colorectal cancer
robotic surgery
minimally invasive surgery
title Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
title_full Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
title_fullStr Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
title_full_unstemmed Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
title_short Right Colectomy with Complete Mesocolic Excision and Intracorporeal Anastomosis: A Monocentric, Single-Surgeon Comparison of Dexter, DaVinci and Laparoscopic Approaches
title_sort right colectomy with complete mesocolic excision and intracorporeal anastomosis a monocentric single surgeon comparison of dexter davinci and laparoscopic approaches
topic CME
hemicolectomy
colorectal cancer
robotic surgery
minimally invasive surgery
url https://www.mdpi.com/2075-1729/15/7/1122
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