Robot-Assisted Radical Nephrectomy Using the Novel Avatera Robotic Surgical System: A Feasibility Study in a Porcine Model

Gkeka, Kristiana; Tsaturyan, Arman; Faitatziadis, Solon; Peteinaris, Angelis; Anaplioti, Eirini; Pagonis, Konstantinos; Vagionis, Athanasios; Tatanis, Vasileios; Vrettos, Theofanis; Kallidonis, Panagiotis; Liatsikos, Evangelos

doi:10.1089/end.2022.0596

Cited by 13 publications

(6 citation statements)

References 23 publications

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“…Two joystick hand controllers with straps and finger clutches Six-foot pedals for electrosurgery, camera and instrument switch Eyepiece designed to leave ears and mouth uncovered Instruments: Single use (except reusable endoscope), 5mm. Only bipolar available currently Ergonomics : Built-in ergonomic chair, adjustable settings, stereoscopic eyepiece with headrest, ears “free” for communicating Vision: 3D stereoscopic magnified view QXGA resolution (2048 × 1536px), overlay information on instruments, electrosurgery usage, statuses, and alarms Portability: Easily moved by one person between rooms through standard doors Additional highlights : Next generation in development The current system is very quiet within the OR due to no external fans Modular training is available for the whole team with VR, Dry and wet (animal) lab Proctors available for onsite training with performance evaluation Virtual reality : In system simulation available Stage 1 Supporting evidence: Stage 0: Feasibility of robotic bilateral nephrectomy and radical cystectomy live porcine models [ 85 , 86 ] Pending 2b: A current multicentre trial is running and registered on ISRCTN45854742 Mantra Surgical Robotic System, M/S. Sudhir, Srivastava Innovations (SSI) PVT.…”

Section: Resultsmentioning

confidence: 99%

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Evaluation status of current and emerging minimally invasive robotic surgical platforms

Boal,

Di Girasole,

Tesfai

et al. 2023

Surg Endosc

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Background The rapid adoption of robotics within minimally invasive surgical specialties has also seen an explosion of new technology including multi- and single port, natural orifice transluminal endoscopic surgery (NOTES), endoluminal and “on-demand” platforms. This review aims to evaluate the validation status of current and emerging MIS robotic platforms, using the IDEAL Framework. Methods A scoping review exploring robotic minimally invasive surgical devices, technology and systems in use or being developed was performed, including general surgery, gynaecology, urology and cardiothoracics. Systems operating purely outside the abdomen or thorax and endoluminal or natural orifice platforms were excluded. PubMed, Google Scholar, journal reports and information from the public domain were collected. Each company was approached via email for a virtual interview to discover more about the systems and to quality check data. The IDEAL Framework is an internationally accepted tool to evaluate novel surgical technology, consisting of four stages: idea, development/exploration, assessment, and surveillance. An IDEAL stage, synonymous with validation status in this review, was assigned by reviewing the published literature. Results 21 companies with 23 different robotic platforms were identified for data collection, 13 with national and/or international regulatory approval. Of the 17 multiport systems, 1 is fully evaluated at stage 4, 2 are stage 3, 6 stage 2b, 2 at stage 2a, 2 stage 1, and 4 at the pre-IDEAL stage 0. Of the 6 single-port systems none have been fully evaluated with 1 at stage 3, 3 at stage 1 and 2 at stage 0. Conclusions The majority of existing robotic platforms are currently at the preclinical to developmental and exploratory stage of evaluation. Using the IDEAL framework will ensure that emerging robotic platforms are fully evaluated with long-term data, to inform the surgical workforce and ensure patient safety. Graphical abstract

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Section: Resultsmentioning

confidence: 99%

“…Stage 0: Feasibility of robotic bilateral nephrectomy and radical cystectomy live porcine models [ 85 , 86 ]…”

Section: Resultsmentioning

confidence: 99%

Evaluation status of current and emerging minimally invasive robotic surgical platforms

Boal,

Di Girasole,

Tesfai

et al. 2023

Surg Endosc

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“…Several new robotic systems have emerged in the market since the introduction of the Senhance® Telerobotic system at the end of 2016. [16][17][18][19] The introduction of new surgical systems has given rise to several practical, technical and patient considerations. The technical setup with the Medtronic Hugo™ RAS system is significantly different from the DaVinci® Surgical System and we explored the consequences of this with three measurements of team performance: ing time was 17 minutes, which is slightly longer than the reported 5-15 minutes for the DaVinci® Surgical System.…”

Section: Discussionmentioning

confidence: 99%

First experience with the Hugo™ robot‐assisted surgery system for endometriosis: A descriptive study

Olsen,

Hartwell,

Dalsgaard

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionThe Medtronic Hugo™ Robot‐assisted Surgery (RAS) system was recently approved for clinical use. We explored the safety and feasibility of this system for endometriosis surgery. The primary outcome was safe case completion without major surgical complications (Clavien–Dindo grade ≤2) and no conversion to open surgery or laparoscopy.Material and methodsSurgeries for endometriosis performed at the Department of Gynecology, Rigshospitalet, on the Medtronic Hugo™ RAS system were included. Two experienced robotic surgeons performed all surgeries with their usual robotic team. The variables included were patient demographics, peri‐ and postoperative data, complications and 30‐day readmission rate. We used the IDEAL framework 1/2a for surgical innovation in this descriptive study.ResultsThe first 12 patients were included. All cases were completed without intraoperative complications or conversion. Four patients experienced Clavien–Dindo grade 1 postoperative complications. No patients were re‐admitted within 30 days. Median docking time (17 minutes), console time (87.5 minutes), blood loss (40 mL) and length of hospital stay (1 day) were acceptable compared with previous literature.ConclusionsIn this pilot study, we found the Medtronic Hugo™ RAS system safe and feasible for robot‐assisted surgery for endometriosis. The advent of new robotic systems is welcomed to accelerate the development of technology that will advance surgical care for patients across the globe.

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“…While no clinical series have been published to date, feasibility studies of robot-assisted radical nephrectomy and radical cystectomy with ileal neobladder using this novel system in a porcine model were recently published. 51 , 52 In an SWOT (strengths, weaknesses, opportunities, threats) analysis looking at the projected market costs of this system, Liatsikos et al 53 calculated that the elimination of sterilization costs of instruments could potentially translate into a cost reduction of €800–900 for a standard radical prostatectomy in Greece.…”

Section: Methodsmentioning

confidence: 99%

New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology

Salkowski,

Checcucci,

Chow

et al. 2023

Therapeutic Advances in Urology

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Over the past 20 years, the field of robotic surgery has largely been dominated by the da Vinci robotic platform. Nevertheless, numerous novel multiport robotic surgical systems have been developed over the past decade, and some have recently been introduced into clinical practice. This nonsystematic review aims to describe novel surgical robotic systems, their individual designs, and their reported uses and clinical outcomes within the field of urologic surgery. Specifically, we performed a comprehensive review of the literature regarding the use of the Senhance robotic system, the CMR-Versius robotic system, and the Hugo RAS in urologic procedures. Systems with fewer published uses are also described, including the Avatera, Hintori, and Dexter. Notable features of each system are compared, with a particular emphasis on factors differentiating each system from the da Vinci robotic system.

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Robot-Assisted Radical Nephrectomy Using the Novel Avatera Robotic Surgical System: A Feasibility Study in a Porcine Model

Cited by 13 publications

References 23 publications

Evaluation status of current and emerging minimally invasive robotic surgical platforms

Evaluation status of current and emerging minimally invasive robotic surgical platforms

First experience with the Hugo™ robot‐assisted surgery system for endometriosis: A descriptive study

New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology

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