Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS

Abstract

IntroductionRobotic assisted surgery is a rapidly developing field of minimally invasive bariatric surgery in the last 20 years. Its wide diffusion has led to the development and standardization of robotic assisted approaches for bariatric operations. In this study, we present the first four Roux-en-Y Gastric Bypass (RYGB) operations performed with the new Hugo™ RAS system (Medtronic, Minneapolis, MN, USA).MethodsIn January and February 2023, 4 consecutive patients scheduled for minimal invasive Roux-en-Y-Bypass were selected and underwent the procedure robotic-assisted with the new platform. No exclusion criteria were applied.ResultsFour patients, two females and two males, underwent RYGB with a median BMI of 40 Kg/m2 (range: 36–46) and diabetes mellitus in two cases. The median docking time was 8 min (range: 7–8.5) and the median console time was 127.5 min (range: 95–150). A description of the operating theatre, robotic arms and docking setup is provided. Procedures were performed without intraoperative complications and no conversion to laparoscopy or open surgery was noted. No additional ports were needed to be placed. System's function and docking were uneventful. No early post-operative complications were observed.ConclusionsBased on our initial experience, RYGB with the Hugo™ RAS system is feasible. This study provides the configurations necessary to perform RYGB with the Hugo™ RAS system as well as general information and insights from our preliminary experience.

Preclinical Setup Standardization of the Novel HugoTM Robotic Platform for Upper Gastrointestinal Surgery

“…Ciccoritti et al published the rst 4 patients that underwent to Roux-en-Y-Bypass, with median docking time of 8 min and median console time was 127.5 min. Nor complications, neither technical issues were recorded 14 . Mintz et al came out with his series of 13 inguinal hernia repair performed with the Hugo™ RAS.…”

“…Another limitation is related to using cadavers, which lack all the physiological features found in real patients. Nevertheless, as mentioned earlier, our models have already been successfully applied in clinical settings [14][15][16] .…”

“…This demonstrates that Hugo™ is safe and effective in performing UGI surgery.The data obtained from this preclinical study has allowed to standardize the approach to the abdominal upper quadrants with Hugo™. Although it's a preclinical work, the initial clinical experiences that have been published so far are con rming our results.Hugo™ RAS have already used our suggested setup [14][15][16][17] , we advocate that our standardization would be adopted in a more widespread fashion, to improve e ciency and reproducibility.…”

“…Hugo™ RAS have already used our suggested setup [14][15][16][17] , we advocate that our standardization would be adopted in a more widespread fashion, to improve e ciency and reproducibility.…”

Robotic-assisted Roux-en-Y gastric bypass with the novel platform HugoTM RAS: preliminary experience in 15 patients

“…This was only possible after the platform received CE approval also for general surgery (October 2022). The safety and feasibility of the Hugo™ RAS platform has already been tested in urological [ 12 , 13 ], gynaecological [ 14 , 15 ], bariatric [ 16 ] and adrenal procedures [ 11 ], while the first report of its application in colorectal surgery has also been very recently reported [ 17 ]. However, there are no reports thus far, with enough clinical evidence, exploring if the transition to novel robotic platforms in robotic centres is an uneventful process, without requiring a long adaptation period.…”