Objective: To report the outcomes of intra- and extra-peritoneal robot-assisted radical prostatectomy (RARP) and robot-assisted radical cystectomy (RARC) with Hugo™ robot-assisted surgery (RAS) system (Medtronic, Minneapolis, MN, USA).
Methods: Data of twenty patients who underwent RARP and one RARC at our institution between February 2022 and January 2023 were reported. The primary endpoint of the study was to report the surgical setting of Hugo™ RAS system to perform RARP and RARC. The secondary endpoint was to assess the feasibility of RARP and RARC with this novel robotic platform and report the outcomes.
Results: Seventeen patients underwent RARP with a transperitoneal approach, and three with an extraperitoneal approach; and one patient underwent RARC with intracorporeal ileal conduit. No intraoperative complications occurred. Median docking and console time were 12 (interquartile range [IQR] 7-16) min and 185 (IQR 177-192) min for transperitoneal RARP, 15 (IQR 12-17) min and 170 (IQR 162-185) min for extraperitoneal RARP. No intraoperative complications occurred. One patient submitted to extraperitoneal RARP had a urinary tract infection in the postoperative period that required an antibiotic treatment (Clavien-Dindo Grade 2). In case of transperitoneal RARP, two minor complications occurred (one pelvic hematoma and one urinary tract infection; both Clavien-Dindo Grade 2).
Conclusion: Hugo™ RAS system is a novel promising robotic platform that allows to perform major oncological pelvic surgery. We showed the feasibility of RARP both intra- and extra-peritoneally and RARC with intracorporeal ileal conduit with this novel platform.
. [J]. Asian Journal of Urology, 2023, 10(4): 461-466.
Angelo Territo, Alessandro Uleri, Andrea Gallioli, Josep Maria Gaya, Paolo Verri, Giuseppe Basile, Alba Farré, Alejandra Bravo, Alessandro Tedde, Óscar Rodríguez Faba, Joan Palou, Alberto Breda. Robot-assisted oncologic pelvic surgery with Hugo™ robot-assisted surgery system: A single-center experience. Asian Journal of Urology, 2023, 10(4): 461-466.
UTI that required antibiotic treatment (CD Grade 2)
1 (5.9)
Pelvic bleeding that required a TAE (CD Grade 3a)
1 (5.9)
Estimated blood lossa, mL
200 (150-250)
Length of hospital staya, day
3 (2-4)
ISUP grade group at final pathologyb
ISUP 1
1 (5.9)
ISUP 2
9 (52.9)
ISUP 3
5 (29.4)
ISUP 4
0 (0)
ISUP 5
2 (11.8)
T stage at final pathologyb
pT2
14 (82.4)
pT3a
3 (17.6)
Positive surgical marginb
5 (29.4)
Postoperative PSA at 3 monthsa, ng/mL
0.009 (0.006-0.045)
Characteristic
Patient
No. 1
No. 2
No. 3
Age, year
65
62
56
BMI, kg/m2
27
24
26
PSA, ng/mL
4.4
30.0
5.4
ISUP grade group at biopsy
2
2
1
Prostate volume at MRI, mL
46
55
34
ECE at MRI
0
0
0
DRE
Negative
Negative
Positive
Docking time, min
20
15
10
Console time, min
200
170
155
Postoperative complications
0
UTI (CD Grade 2)
0
Estimated blood loss, mL
150
250
100
Length of hospital stay, day
3
3
4
ISUP grade group at final pathology
3
3
2
T stage at final pathology
2
3a
2
Positive surgical margin
0
1
0
Postoperative PSA at 3 months, ng/mL
0.002
0.180
0.003
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