Robot-Assisted Pyeloplasty with HUGO™ Robotic System: Initial Experience and Optimal Surgical Set-Up at a Tertiary Referral Robotic Center.

Journal: Journal of endourology
Published Date:

Abstract

In February 2021 Medtronic (Minneapolis, MN) launched the HUGO™ Robot-Assisted Surgery (RAS) System in the global market. The aim of the current study is to describe the first case series and the optimal setup of robot-assisted pyeloplasty procedure, performed with HUGO RAS system in a tertiary referral robotic center. Data from consecutive patients who underwent robot-assisted pyeloplasty at Onze-Lieve-Vrouwziekenhuis Hospital (Aalst, Belgium) were recorded. Baseline characteristics, and perioperative and surgical outcomes were collected. Overall, 10 robot-assisted pyeloplasties were performed (October 2022-September 2023). Based on our expertise, the following minor setting changes have been made, relative to the official setup guide: the endoscope port and, subsequently, the left and right-hand ports were positioned more laterally. Additionally, the reserve/4th port was placed more laterally and cranially, and adjusted the arm cart's tilt angle, reducing it from -30° to -15°. The median docking time was 8 (interquartile range [IQR]: 7.2-9.8) minutes, and the median active console time was 89.5 (80.0-95.8) minutes. No conversion to open/laparoscopic surgery or perioperative complications was encountered. A single technical problem was recorded in 1 (10%) procedure. Specifically, one arm was blocked, and the procedure was accomplished with three arms without compromising the procedure success. This study represents the first worldwide series of robot-assisted pyeloplasty performed with the HUGO RAS system and shows promising results. The procedure might be safely performed with this robotic platform achieving optimal perioperative outcomes.

Authors

  • Silvia Rebuffo
    Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy.
  • Marco Ticonosco
    Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
  • Claudia Collà Ruvolo
    Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples Federico II, Naples, Italy.
  • Alessandro Pissavini
    Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.
  • Eleonora Balestrazzi
    Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Marco Paciotti
    Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Nicola Frego
    Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy.
  • Gabriele Sorce
    Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; ORSI Academy, Ghent, Belgium; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Mario Belmonte
    Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.
  • Maria Peraire Lores
    Department of Urology, Son Espases University Hospital, Palma de Mallorca, Spain.
  • Adele Piro
    ORSI Academy, Ghent, Belgium.
  • Federico Piramide
    Department of Urology, "San Luigi Gonzaga" Hospital, University of Turin, Orbassano (Turin), Italy.
  • Carlo Andrea Bravi
    Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Melle, Belgium; Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Ruben De Groote
    ORSI Academy Melle Belgium.
  • Alexandre Mottrie
    ORSI Academy Melle Belgium.
  • Geert De Naeyer
    General Surgery and Urology. OLV Hospital. Belgium.