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Minerva Urology and Nephrology 2022 Sep 12

DOI: 10.23736/S2724-6051.22.05031-5


language: English

Robot-assisted simple prostatectomy with the novel HUGO™ RAS System: feasibility, setting, and perioperative outcomes

Angelo MOTTARAN 1, 2, 3 , Marco PACIOTTI 1, 2, 4, 5, Carlo A. BRAVI 1, 2, Luca SARCHI 1, 2, Luigi NOCERA 1, 2, 6, Adele PIRO 1, 2, 7, Rui FARINHA 1, Pieter DE BACKER 1, Pietro PIAZZA 1, 2, 3, Kim PAUWAERT 2, Manoe van HERWAARDEN 2, Ruben DE GROOTE 1, 2, Alexandre MOTTRIE 1, 2, Geert DE NAEYER 1, 2

1 ORSI Academy, Ghent, Belgium; 2 Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium; 3 Department of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy; 4 Department of Urology, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy; 5 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; 6 Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; 7 Department of Urology, University of Modena and Reggio Emilia, Modena, Italy


BACKGROUND: Robot-assisted simple prostatectomy (RASP) has demonstrated better peri-operative outcomes as compared to open simple prostatectomy. However, RASP is still limited by platform availability and cost-effectiveness issues. The new surgical robots increasing competition may spread the robotic approach also in non-oncological fields.
METHODS: We reported the first RASP executed in Europe at OLV Hospital (Aalst, BE) performed with the novel HUGO™ Robot-Assisted Surgery (RAS) System. The platform consists of four independent carts, an open console, and a system tower equipped for both laparoscopic and robotic surgery. Our main goal was to demonstrate the technical feasibility of RASP with the novel HUGO™ RAS along with its safety in terms of perioperative outcomes and complications. We also aimed to describe our surgical setup. We collected patient’s baseline characteristics, intraoperative and perioperative complications, postoperative outcomes, docking time, operative time, clashing of the instruments, or technical errors of the system.
RESULTS: The procedure was performed in a 72 years old male with a prostate volume of 155g at preoperative imaging. No need for conversion to open/laparoscopic surgery and/or for additional port placement was required. No intraoperative complications, instrument clashes, or failure of the system that compromised the completion of the surgery were recorded. Docking, operative, and console times were 9, 150, and 120 minutes, respectively. The catheter was removed on the second postoperative day. No postoperative complications occurred. The postoperative uroflowmetry revealed a maximum flow of 26.2 ml/s, without post-void residual volume.
CONCLUSIONS: Robot-assisted simple prostatectomy with the HUGO™ RAS System is a feasible and safe procedure in terms of perioperative outcomes and complications. Our setup allowed for a rapid docking procedure and a smoothly completion of the surgery.

KEY WORDS: Benign prostatic hyperplasia; Robotic surgery; Robot-assisted simple prostatectomy; New robotic platform; Medtronic Hugo™ RAS system

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