Procopio Priscilla Francesca, Pennestrì Francesco, Gallucci Pierpaolo, Laurino Antonio, Martullo Annamaria, De Crea Carmela, Raffaelli Marco
U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.Go 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. 2025 Sep 18. doi: 10.1007/s13304-025-02414-8.
Robot-assisted adrenalectomy (RAA) has emerged as an advantageous approach in challenging cases and suspicious lesions, although high costs represent the main drawback to its broader application. Besides Da-Vinci, new platforms have been recently launched on the market and need to be validated in clinical practice. DaVinci, HUGO™-RAS and Versius platforms were introduced in our center in 2012, 2022, and 2024, respectively. We aimed to compare the perioperative outcomes of these robotic platforms. Among 730 adrenalectomies (2012-2024), 149 (20.4%) RAAs were performed. All procedures performed by means of HUGO™-RAS and Versius platforms were compared with similar procedures (in terms of patient's and lesion's features) performed with the DaVinci technology in the same period (2022-2024). Ten patients were included in each group. Patients' and lesions' features were similar. Median BMI and lesions' size were 27.9, 24.9, and 26.1 kg/m and 42.5, 42.5, and 32.5 mm in DaVinci, HUGO™-RAS, and Versius groups, respectively (p = 0.360, p = 0.236). The groups were comparable for docking time, console time, and operative time (5 vs. 5 vs. 7 min, p = 0.059, 58.5 vs. 58 vs. 39 min, p = 0.393, 109.5 vs. 110.5 vs. 104.1 min, p = 0.668, respectively). No conversion or perioperative complications were registered. Postoperative hospital stays were similar (2 days in all groups, p = 0.629). RAA, whatever platform is used, confirmed to be a safe and effective approach, potentially expanding indications for minimally invasive adrenalectomy. Even though new platforms have been applied in less demanding cases in our learning curve phase, the introduction of new different platforms may lead to a costs reduction, thus to a broader diffusion of RAA.
机器人辅助肾上腺切除术（RAA）已成为处理具有挑战性的病例和可疑病变的一种优势方法，尽管高成本是其更广泛应用的主要障碍。除了达芬奇手术系统外，新的平台最近已投放市场，需要在临床实践中进行验证。达芬奇手术系统、HUGO™-RAS和Versius平台分别于2012年、2022年和2024年引入我们中心。我们旨在比较这些机器人平台的围手术期结果。在730例肾上腺切除术（2012 - 2024年）中，进行了149例（20.4%）RAA手术。将所有通过HUGO™-RAS和Versius平台进行的手术与同期（2022 - 2024年）使用达芬奇技术进行的类似手术（根据患者和病变特征）进行比较。每组纳入10例患者。患者和病变特征相似。达芬奇组、HUGO™-RAS组和Versius组的中位体重指数和病变大小分别为27.9、24.9和26.1kg/m²以及42.5、42.5和32.5mm（p = 0.360，p = 0.236）。各组在对接时间、控制台操作时间和手术时间方面具有可比性（分别为5分钟对5分钟对7分钟，p = 0.059；58.5分钟对58分钟对39分钟，p = 0.393；109.5分钟对110.5分钟对104.1分钟，p = 0.668）。未记录到中转或围手术期并发症。术后住院时间相似（所有组均为2天，p = 0.629）。无论使用何种平台，RAA都被证实是一种安全有效的方法，可能会扩大微创肾上腺切除术的适应症。尽管在我们学习曲线阶段新平台已应用于要求较低的病例，但引入新的不同平台可能会降低成本，从而使RAA得到更广泛的推广。
