U.O. Chrirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, Rome, Italy.
Updates Surg. 2023 Jan;75(1):217-225. doi: 10.1007/s13304-022-01410-6. Epub 2022 Nov 4.
Robotic assisted surgery is the most rapidly developing field of minimally invasive surgery. Its wide diffusion has led to the development and standardization of robotic-assisted approaches also for adrenalectomy. In this study, we present the first five robotic-assisted lateral transabdominal adrenalectomies performed with the new Hugo RAS™ system (Medtronic, Minneapolis, MN, USA). After an official training course of the surgical team, five consecutive patients scheduled for unilateral adrenalectomy, underwent robotic-assisted operations in our institution. Patients that were candidates for partial adrenalectomy were excluded. A description of the operating theatre, robotic arms and docking setup is provided. Four female and one male patient underwent lateral transabdominal adrenalectomy, three for lesions on the left side and two on the right. Median lesion size was 3.9 cm (range: 30-90) and preoperative diagnosis was Cushing's syndrome in three patients, an adrenal cystic lesion and a pheochromocytoma. The median docking time was 5 min (range: 5-8) and the median console time was 55 min (range: 29-108). Procedures were performed without intraoperative complications and no conversions or additional ports were needed. System's function and docking were uneventful. Based on our initial experience, adrenalectomy with the Hugo™ system is feasible. This study provides technical notes for other centres that wish to perform robotic-assisted adrenalectomies with the Hugo™ RAS as well as general information and our preliminary insights on this new platform.
机器人辅助手术是微创外科发展最快的领域。它的广泛传播导致了机器人辅助方法的发展和标准化，也用于肾上腺切除术。在这项研究中，我们展示了使用新的 Hugo RAS™系统（美敦力，明尼苏达州明尼阿波利斯，美国）进行的首例五次机器人辅助侧腹腔肾上腺切除术。在手术团队的正式培训课程之后，我们机构对五名连续的单侧肾上腺切除术患者进行了机器人辅助手术。排除了适合部分肾上腺切除术的患者。提供了手术室、机器人手臂和对接设置的描述。四名女性和一名男性患者接受了侧腹腔肾上腺切除术，其中三人在左侧，两人在右侧。中位病变大小为 3.9cm（范围：30-90），术前诊断为三名患者的库欣综合征、一个肾上腺囊性病变和一个嗜铬细胞瘤。中位对接时间为 5 分钟（范围：5-8），中位控制台时间为 55 分钟（范围：29-108）。手术过程中没有出现并发症，也没有需要转换或额外的端口。系统功能和对接都很顺利。根据我们的初步经验，使用 Hugo™系统进行肾上腺切除术是可行的。本研究为其他希望使用 Hugo™RAS 进行机器人辅助肾上腺切除术的中心提供了技术说明，并提供了有关该新平台的一般信息和我们的初步见解。
