HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse

Abstract

Background: Minimally invasive sacral colpopexy is considered the gold standard for surgical treatment of Pelvic Organ Prolapse (POP), combining high success rates with low recurrence risk in comparison to other techniques. This is the first case of robotic sacral colpopexy (RSCP) performed with the innovative Hugo™ RAS robotic system. Objectives: The aim of this article is to show the surgical steps of a nerve sparing RSCP performed with the new Hugo™ RAS robotic system (Medtronic), by also evaluating the feasibility of this technique using this novel Robotic System. Materials and methods: A 50-year-old Caucasian woman with symptomatic pelvic organ prolapse (POP-Q): Aa: +2, Ba: +3, C: +4, D: +4, Bp: -2, Ap: -2 , TVL:10 GH: 3,5 BP:3 underwent RSCP as well as a subtotal hysterectomy with bilateral salpingo-oophorectomy, using the new surgical robot Hugo™ RAS in the Division of Urogynaecology and Pelvic Reconstructive Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Main outcome measures: Intraoperative data, docking specifics, objective and subjective outcomes at three months follow up. Results: Surgical procedure was carried out without intra-operative complications, operative time (OT) was 150 minutes, docking time was 9 minutes. No system errors or faults in the robotic arms were registered. Urogynaecological examination at three months follow up showed a complete resolution of the prolapse. Conclusion: RSCP using the Hugo™ RAS system seems to be a feasible and effective approach according to results in terms of operative time, cosmetic results, postoperative pain and length of hospitalisation. Large number of case reports as well as longer follow up are mandatory to better define its benefits, advantages, and costs.

A comparative analysis of the HUGOTM robot‐assisted surgery system and the Da Vinci® Xi surgical system for robot‐assisted sacrocolpopexy for pelvic organ prolapse treatment

“…Our results are consistent with those described by Panico et al 12 However, in their series of 60 RASCs with HUGO TM RAS system, fifty-six (93.3%) patients had associated procedures, including 49 subtotal hysterectomies, 1 total hysterectomy, and 49 salpingoophorectomies. Therefore, a full comparison with our results in terms of intra-and post-operative outcomes cannot be done.…”

Robotic Medtronic Hugo™ RAS System Is Now Reality: Introduction to a New Simulation Platform for Training Residents

“…In the robotic surgical landscape, the Hugo™ RAS System represents a novel promising robotic platform that is currently available in many robotic referral institutions, with applications in urological [20,21] and non-urological surgeries [22][23][24]. The spread of this new technology seems to be related to its extremely wide range of adaptability and to a fast LC in experienced robotic surgeons [25][26][27].…”

En-block butterfly excision of posterior compartment deep endometriosis: The first experience with the new surgical robot Hugo™ RAS

“…Most of the new robotic platforms are still not on the market and validation studies in the different fields are ongoing to demonstrate the safety and feasibility of these devices. Studies on the application of this robotic device to gynaecological procedures were carried out ( Monterossi et al, 2022 ), and uro-gynaecological surgeries have been described ( Panico et al, 2023 ). To date, this is the first video showing the feasibility of the HugoTM RAS assisted surgery in patients affected by endometriosis involving large bowel.…”