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使用 Hugo RAS 系统的“三臂设置”机器人辅助根治性前列腺切除术的安全性和可行性:来自双中心大病例系列的手术设置。

Safety and feasibility of "three arms settings" robot-assisted radical prostatectomy using the Hugo RAS system: surgical set-up in a double-center large case series.

机构信息

Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Department of Urology, GVM - Maria Pia Hospital, Torino, 10132, Italy.

出版信息

World J Urol. 2024 Sep 11;42(1):517. doi: 10.1007/s00345-024-05210-y.

Abstract

PURPOSE

Robot-assisted laparoscopic radical prostatectomy (RARP) is the most common robotic procedures performed in urologic oncology. The Hugo Robot-Assisted Surgery (RAS) System (Medtronic, USA©) has recently been launched on the market and is characterized by the modularity of four different independent arm carts. The aim of this study is to describe and evaluate safety and feasibility of three-arms setting for RARP using the Hugo RAS™ System in a large case series.

METHODS

Between October 2022 and December 2023, a large case series of patients from two tertiary referral center who underwent RARP through HUGO™ RAS were prospectively enrolled. Informed written consent was obtained before the procedure and a three-arms setting was used in every case. Follow-up was scheduled according to EAU guidelines.

RESULTS

A total of 86 patients were included in this study and underwent RARP with Hugo™ RAS System. Median Console time time was 114 min (IQR, 75-150), median docking time 4 min (IQR, 3-5). Lymphadenectomy was successfully performed when indicated in 19 patients (22.1%). A vesicourethral anastomosis using the modified Van Velthoven technique was successfully achieved in all cases. No post-operative complications > Clavien II up to 30 post-operative days were reported. In all patients, catheter was removed on the 7th postoperative day.

CONCLUSION

We conducted the first large case series of RARP through the novel Hugo™ RAS System using a three-arms configuration. This innovative robotic platform showed an easily accessible docking system, providing excellent perioperative outcomes.

摘要

目的

机器人辅助腹腔镜前列腺根治术(RARP)是泌尿外科肿瘤学中最常见的机器人手术。Hugo 机器人辅助手术(RAS)系统(美敦力,美国©)最近已投放市场,其特点是四个独立机械臂推车的模块化。本研究旨在描述和评估使用 Hugo RAS™ 系统在大系列病例中进行 RARP 的三臂设置的安全性和可行性。

方法

2022 年 10 月至 2023 年 12 月,来自两家三级转诊中心的患者前瞻性地纳入了这项研究,这些患者通过 HUGO™ RAS 接受了 RARP。在手术前获得了知情书面同意,并在每种情况下都使用了三臂设置。随访根据 EAU 指南进行。

结果

本研究共纳入 86 例患者,均采用 Hugo™ RAS 系统行 RARP。控制台中位时间为 114 分钟(IQR,75-150),中位对接时间为 4 分钟(IQR,3-5)。在 19 例有指征的患者中成功进行了淋巴结切除术(22.1%)。所有病例均成功完成了改良 Van Velthoven 技术的膀胱尿道吻合术。在 30 天的术后随访期内,没有报告任何术后并发症 > Clavien II 级。所有患者均于术后第 7 天拔除导尿管。

结论

我们使用新型 Hugo™ RAS 系统进行了首例大系列 RARP,采用了三臂配置。这种创新的机器人平台显示出易于接近的对接系统,提供了出色的围手术期结果。

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