Quezada Nicolas, Irarrazaval Maria Jesus, Chen David C, Grimoldi Milenko, Pimentel Fernando, Crovari Fernando
Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, 362 Diagonal Paraguay, 4th Floor, Office 410, Región Metropolitana, Santiago, Chile.
Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Surg Endosc. 2024 Jun;38(6):3395-3404. doi: 10.1007/s00464-024-10865-0. Epub 2024 May 8.
Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®).
All consecutive patients who underwent a rTAR in our institution were included. Three of the four arm carts of the HUGO RAS System were used at any given time. Each arm configuration was defined by our team in conjunction with Medtronic® personnel. rTAR was performed as previously described. Upon completion of the TAR on one side, a redocking process with different, mirrored arms angles was performed to continue with the contralateral TAR. Operative variables and early morbidity were recorded.
Ten patients were included in this study. The median BMI was 31 (21-40.6) kg/m. The median height was 1.6 m (1.5-1.89 m). A trend of decreased operative time, console time, and redocking time was seen in these consecutive cases. No intraoperative events nor postoperative morbidity was reported. The median length of stay was 3 (1-6) days.
Robotic TAR utilizing the HUGO RAS system is a feasible and safe procedure. The adoption of this procedure on this novel platform for the treatment of complex abdominal wall hernias has been successful for our team.
腹横肌松解术（TAR）是治疗大型中线和中线旁疝的有效技术。最近的研究表明，与开放手术相比，机器人辅助腹横肌松解术（rTAR）在技术上是可行的，且预后更佳。迄今为止，尚无使用新型机器人平台HUGO RAS系统（美敦力公司）进行腹壁重建的相关经验报道。
纳入在我院接受rTAR的所有连续病例。在任何给定时间使用HUGO RAS系统的四个臂架中的三个。每种臂架配置均由我们的团队与美敦力公司人员共同确定。rTAR按照先前描述的方法进行。在一侧完成TAR后，以不同的镜像臂架角度进行重新对接操作，以继续对侧的TAR。记录手术变量和早期并发症情况。
本研究共纳入10例患者。中位体重指数为31（21 - 40.6）kg/m²。中位身高为1.6 m（1.5 - 1.89 m）。在这些连续病例中，观察到手术时间、控制台操作时间和重新对接时间有缩短趋势。未报告术中事件及术后并发症。中位住院时间为3（1 - 6）天。
使用HUGO RAS系统进行机器人辅助TAR是一种可行且安全的手术方法。对于我们的团队而言，在这个新型平台上采用该手术方法治疗复杂腹壁疝已取得成功。
