Quantitative Visualization of Console Behavior During Robot-Assisted Radical Prostatectomy Using the Da Vinci 5 System: A Case-Based Technical Report

利用达芬奇5系统进行机器人辅助根治性前列腺切除术中控制台行为的定量可视化:基于病例的技术报告

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Abstract

Robot-assisted radical prostatectomy (RARP) using the da Vinci system (Intuitive Surgical, Inc., Sunnyvale, CA) has become a standard minimally invasive treatment for nonmetastatic prostate cancer. The next-generation da Vinci 5 system incorporates integrated motion analytics and force-feedback instruments, enabling quantitative visualization of console behavior during robotic surgery. In this case-based technical report, we describe our initial real-world experience with these functions in two patients who underwent RARP at a single institution. Both procedures were performed via a standard transperitoneal approach without pelvic lymph node dissection, and perioperative outcomes were acceptable in both cases. Digital logs obtained from the cloud-based My Intuitive platform (Intuitive Surgical) provided instrument-tip force categories, kinematic metrics including instrument and endoscope path lengths, and system events such as endoscope clutches, hand-controller clutches, and energy-pedal activations. The procedures were automatically segmented into three steps by the My Intuitive platform algorithm, and the analytics were reviewed in synchronization with the corresponding operative videos. Quantitative review demonstrated differing patterns of console motion, clutch use, and force application between the two analyzed procedures, particularly during dissection between the rectum and prostate and during vesicourethral anastomosis. Case 1 showed more frequent clutch use and a broader working range, whereas Case 2 showed a higher proportion of time categorized as force ≥ 6.5 N despite similar mean forces. This report demonstrates the technical feasibility of capturing, synchronizing, and visualizing console behavior using the integrated analytics of the da Vinci 5 system during RARP. Although the findings are descriptive and hypothesis-generating only, this integrated review approach may have potential value for structured technical reflection, data-guided feedback, and future surgical education research.

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