Three‐arms off‐clamp robot‐assisted partial nephrectomy with the new Hugo robot‐assisted surgery system

Prata, Francesco; Ragusa, Alberto; Anceschi, Umberto; Iannuzzi, Andrea; Tedesco, Francesco; Cacciatore, Loris; Civitella, Angelo; Tuzzolo, Piergiorgio; Cirillo, Roberto; Callè, Pasquale; Raso, Gianluigi; Fantozzi, Marco; Pira, Matteo; Prata, Salvatore Mario; Simone, Giuseppe; Scarpa, Roberto Mario; Papalia, Rocco

doi:10.1111/bju.16166

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…Another significant aspect of our approach is the enhanced role of the bedside assistant, enabled by the use of two laparoscopic instruments. This setup allows for the simultaneous use of two surgical suctions with irrigation, improving the visualization of tumor borders during enucleation and precise differentiation between healthy renal parenchyma and the renal mass [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Hugo™ RAS Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Technique and Initial Experience

Prata,

Iannuzzi,

Tedesco

et al. 2024

JCM

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Background: The Hugo™ Robot-Assisted Surgery (RAS) system is a new cutting-edge robotic platform designed for clinical applications. Nevertheless, its application for cystic renal tumors has not yet been thoroughly investigated. In this context, we present an initial series of Robot-Assisted Partial Nephrectomy (RAPN) procedures carried out using the Hugo™ RAS system for cystic renal masses. Methods: Between October 2022 and January 2024, twenty-seven RAPN procedures for renal tumors were performed at Fondazione Policlinico Universitario Campus Bio-Medico. Our prospective board-approved dataset was queried for “cystic features” (n = 12). Perioperative data were collected. The eGFR was calculated according to the CKD-EPI formula. Post-operative complications were reported according to the Clavien–Dindo classification. Computed tomography (CT) scans for follow-up were performed according to the EAU guidelines. Trifecta was defined as the coexistence of negative surgical margin status, no Clavien–Dindo grade ≥ 3 complications, and eGFR decline ≤ 30%. Results: All the patients successfully underwent RAPN without the need for conversion or additional port placement. The median docking and console time were 5.5 (IQR, 4–6) and 79.5 min (IQR, 58–91 min), respectively. No intraoperative complications occurred, as well as clashes between instruments or with the bedside assistant. Two minor postoperative complications were recorded (Clavien–Dindo II). At discharge, serum creatinine and eGFR were comparable to preoperative values. Only one patient (8.4%) displayed positive surgical margins. The rate of trifecta achievement was 91.7%. Conclusions: RAPN for cystic renal masses using the novel Hugo™ RAS system can be safely and effectively performed. This robotic system provided satisfactory peri-operative outcomes, preserving renal function and displaying low postoperative complications and a high trifecta rate achievement.

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Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Hugo™ RAS Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Technique and Initial Experience

Prata,

Iannuzzi,

Tedesco

et al. 2024

JCM

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“…Radical prostatectomy actually represents the most common surgical procedure performed in urology, either with an open approach or through laparoscopic-and robotassisted techniques. Minimally invasive surgical procedures have become a cornerstone of perioperative care in surgical patients [15], as they deliver comparable oncological outcomes with potentially improved postoperative functional results, recovery, pain relief, and satisfaction. The continuous refinement of treatment options for the management of urological malignancies supports the patient-centered model of care based on the principle of informed and collaborative decision-making between patients and healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Management after Radical Prostatectomy: Results from a Single Center Study

Civitella,

Prata,

Papalia

et al. 2023

JPM

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(1) Background: Regional anesthesia, achieved through nerve blocks, has gained widespread acceptance as an effective pain management approach. This research aimed to evaluate the efficacy of laparoscopic (LAP) transversus abdominis plane (TAP) block in patients undergoing laparoscopic radical prostatectomy. (2) Methods: From January 2023 to July 2023, 60 consecutive patients undergoing minimally invasive radical prostatectomy were selected. Patients were split into two groups receiving ultrasound-guided (US) or laparoscopic-guided TAP block. The primary outcome was a pain score expressed by a 0−10 visual analog scale (VAS) during the first 72 h after surgery. (3) Results: Both LAP-TAP and US-TAP block groups were associated with lower pain scores postoperatively. No statistically significant differences were observed between the two groups in surgery time, blood loss, time to ambulation, length of stay, and pain after surgery (all p > 0.2). In the LAP-TAP block group, the overall operating room time was significantly shorter than in the US-TAP block group (140 vs. 152 min, p = 0.04). (4) Conclusions: The laparoscopic approach, compared to the US-TAP block, was equally safe and not inferior in reducing analgesic drug use postoperatively. Moreover, the intraoperative LAP-TAP block seems to be a time-sparing procedure that could be recommended when patient-controlled analgesia cannot be delivered.

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“…Trocar configuration in RAPN using the Hugo™ RAS System was recently described in a three-arms setting [14,22], which involved an initial 11 mm robotic camera trocar along the pararectal line, positioned approximately 14 ± 2 cm away from the umbilicus. Two additional 8 mm operative robotic ports were placed under direct vision caudal to the endoscope trocar, which ensured appropriate distances from the optical port.…”

Section: Trocar Configuration and Surgical Proceduresmentioning

confidence: 99%

“…For this reason, robot-assisted partial nephrectomy (RAPN) has taken the upper hand in the field of minimally invasive nephron-sparing surgery (NSS), providing benefits for both patients and surgeons. RAPN empowered surgeons to overcome the technical challenges associated with laparoscopy, becoming a widely recognized standard option, pushing its indications to all clinical T1 RCCs and, in specific cases, even for T2 renal masses [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Trifecta Outcomes of Robot-Assisted Partial Nephrectomy Using the New Hugo™ RAS System Versus Laparoscopic Partial Nephrectomy

Prata,

Ragusa,

Tedesco

et al. 2024

JCM

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(1) Background: Laparoscopic partial nephrectomy (LPN) is still performed in many referred urological institutions, representing a valid alternative to robot-assisted partial nephrectomy (RAPN). We aimed to compare trifecta outcomes of LPN and RAPN with the Hugo™ RAS System. (2) Methods: Between October 2022 and September 2023, eighty-nine patients underwent minimally invasive partial nephrectomy (group A, RAPN = 27; group B, Laparoscopic PN = 62) for localized renal tumors at our Institution. Continuous variables were presented as median and IQR and compared by means of the Mann–Whitney U test, while categorical variables were presented as frequencies (%) and compared by means of the χ2 test. (3) Results: Group A showed a higher rate of male patients (81.5% vs. 59.7%, p = 0.04) and a higher trend towards larger clinical tumor size (34 vs. 29 mm, p = 0.14). All the other baseline variables were comparable between the two groups (all p > 0.05). Regarding post-operative data, group A displayed a lower operative time (92 vs. 149.5 min, p = 0.005) and a shorter hospital stay (3 vs. 5, p = 0.002). A higher rate of malignant pathology was evidenced in group A (77.8% vs. 58.1%, p = 0.07) as well as a lower trend towards positive surgical margins (3.7% vs. 4.8%, p = 0.82), even if not statistically significant. (4) Conclusions: The rate of trifecta achievement was 92.6% and 82.3% for group A and B (p = 0.10), respectively. In terms of trifecta outcomes, RAPN using the Hugo™ RAS System showed comparable results to LPN performed by the same experienced surgeon.

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Three‐arms off‐clamp robot‐assisted partial nephrectomy with the new Hugo robot‐assisted surgery system

Cited by 12 publications

References 13 publications

Surgical Outcomes of Hugo™ RAS Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Technique and Initial Experience

Surgical Outcomes of Hugo™ RAS Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Technique and Initial Experience

Laparoscopic versus Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Management after Radical Prostatectomy: Results from a Single Center Study

Trifecta Outcomes of Robot-Assisted Partial Nephrectomy Using the New Hugo™ RAS System Versus Laparoscopic Partial Nephrectomy

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