Intuitive Surgical, maker of the surgical robotic device, released their latest iteration in the second quarter of last year – the “Xi” (the prior version being the “Si”). As I approach 6 months of using this technologic marvel, I felt a review was in order.
On my initial use, it was clear that Intuitive Surgical wanted to give the experienced robotic surgeon a familiar working environment. The surgeon’s console – the place where I sit and control the instruments and camera with joysticks – has an almost identical look and feel to its immediate predecessor. The LCD touchpad does differ in layout, reflecting the new software platform and all of its underlying goodies. Some settings – such as focus – are noticeably absent since they have now been automated. Other options – such as scope angle control – help fill the menus. Although I have not had an opportunity to assess the vision quality of the two models side-by-side, the company says that the video quality is even further improved. I find both to be exquisite.
On the patient side of the room, Intuitive Surgical has completely overhauled the computerized robotic arms that interface with the camera and surgical instruments. I can describe the improvements as thinner, sleeker, smoother, and more mobile. I still don’t understand how, but the engineers have managed to position the external portions of the arms much closer while giving the internal instruments an even wider range of motion (i.e. even better surgeon access to difficult-to-reach anatomy). As icing on the cake, the video scope is now compatible with any of the access tubes, giving the surgeon the option of viewing the anatomy from various angles (the predecessors all had a solely-dedicated camera access tube).
Of course, there is always room for improvement. Every time an instrument is changed, it goes through a self-check routine that can take a few seconds. Hopefully, this will improve with a software upgrade. Also, since the camera scope now goes through a smaller tube, placement of the initial access tube can be cumbersome. Intuitive Surgical could easily solve this problem be providing products to accommodate the two most common access methods – a visual obturator for needle access and a Hasson adapter for open access. Lastly, at the risk of being too picky, the sterile plastic drapes that cover the instruments have excess plastic material that can be unnecessarily awkward.
So does the Xi make its predecessor obsolete? Absolutely not. The Si is an incredible surgical tool and will remain relevant for years to come. Is the Xi worth the higher price tag? Two thumbs up.