U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Centro di Ricerca di Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, Rome, Italy.
J Robot Surg. 2024 Aug 6;18(1):303. doi: 10.1007/s11701-024-02063-w.
The application of a robotic platform in the bariatric surgical field is intended to enhance the already established advantages of minimally invasive surgery in terms of both technical and clinical outcomes. These advantages are especially relevant for technically challenging multiquadrant operations such as Roux-en-Y Gastric Bypass (RYGB). Consequently, robotic-assisted surgery has emerged as a possible application for bariatric surgeries. The study attempts to assess feasibility and safety of the Hugo-Robotic-Assisted Surgery System (Hugo-RAS) platform compared to the DaVinci Surgical System (DaVinci-SS) with a focus on complication rates and operative times. We retrospectively reviewed bariatric procedures performed from January 2013 until December 2023. We included all robotic RYGBs performed using Hugo-RAS and DaVinci-SS platforms. The study utilized Propensity Score Matching (PSM) analysis to address bias in selection, matching patients based on age, gender, body mass index, comorbidities and past abdominal operations. One hundred thirty-five patients were identified: 90 DaVinci-SS and 45 Hugo-RAS procedures. After PSM, each group consisted of 45 patients. There was no discernible disparity observed in relation to early (≤ 30 days) postoperative complications rate (p = 1), mean operative time (for docking time, console time and total operative time: p = 0.176, p = 0.678, p = 0.229, respectively) and postoperative hospital stay (p = 0.052) between DaVinci-RSS and Hugo-RAS procedures. Our results suggest that application of both Hugo-RAS and DaVinci-SS robotic platforms to RYGB is related to comparable safety profiles. Although DaVinci-SS remains the most widely adopted platform in clinical practice, this study underscores the potential role of the Hugo-RAS to provide effective solutions in robotic bariatric procedures.
机器人平台在减重外科领域的应用旨在增强微创外科在技术和临床结果方面已有的优势。这些优势对于技术上具有挑战性的多象限手术（如 Roux-en-Y 胃旁路术[RYGB]）尤为重要。因此，机器人辅助手术已成为减重手术的一种可能应用。本研究旨在评估 Hugo-Robotic-Assisted Surgery System（Hugo-RAS）平台与 DaVinci Surgical System（DaVinci-SS）相比的可行性和安全性，重点关注并发症发生率和手术时间。我们回顾性分析了 2013 年 1 月至 2023 年 12 月期间进行的减重手术。我们纳入了所有使用 Hugo-RAS 和 DaVinci-SS 平台进行的机器人 RYGB 手术。本研究采用倾向评分匹配（PSM）分析来解决选择偏倚，根据年龄、性别、体重指数、合并症和既往腹部手术对患者进行匹配。共确定了 135 例患者：90 例达芬奇 SS 和 45 例 Hugo-RAS 手术。经过 PSM 后，每组各有 45 例患者。两组在早期（≤30 天）术后并发症发生率（p=1）、平均手术时间（对接时间、控制台时间和总手术时间：p=0.176、p=0.678、p=0.229）和术后住院时间（p=0.052）方面无明显差异。我们的结果表明，将 Hugo-RAS 和 DaVinci-SS 机器人平台应用于 RYGB 与类似的安全性相关。尽管 DaVinci-SS 仍然是临床实践中应用最广泛的平台，但本研究强调了 Hugo-RAS 在机器人减重手术中提供有效解决方案的潜力。
