Surgery of the alimentary tract for benign and malignant disease with the novel robotic platform HUGO^TM RAS. A first world report of safety and feasibility

Abstract

Introduction As robotic surgery increases its reach, novel platforms are being released. We present the first 17 consecutive cases of alimentary tract surgery performed with the HugoTM RAS (Medtronic). Methods patients were selected to undergo surgery from February through April 2023. Exclusion criteria were age <16 years, BMI>60, ASA IV. Results 17 patients underwent ileocaecal resection for Chrons disease (2 M and 1 F) and pseudo‐obstruction of the terminal ileum (1 M), cholecystectomy (3 M and 5 F), subtotal gastrectomy with D2 lymphadenectomy (1 F), sleeve gastrectomy (1 F), hiatal hernia repair with Nissen fundoplication (1 M), right hemicolectomy (1 M) and sigmoidectomy (1 M). No conversion to an open approach or any arm collisions requiring corrective actions were reported. Conclusions Our preliminary experience with the HugoTM RAS point to safety and feasibility for a rather wide spectrum of surgical procedures of the alimentary tract.

Use of HugoTM RAS in General Surgery: The First 70 Cases at a German Centre and a Systematic Review of the Literature

“…Extensive theoretical and practical training offered by the vendor was completed as already mentioned in a previous report by us [4]. The system components of the Hugo RAS platform have been repeatedly described in detail elsewhere [5][6][7].…”

“…Currently, a total of 18 original papers by 11 different teams have been published, most of them coming from Italy (n = 7) and Spain (n = 4). A summary of these is presented in Table 2 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. GERD-gastroesophageal reflux disease; rTAPP-robotic transabdominal patch plasty; rTAR-robotic transversus abdominis release.…”

“…Romero-Marcos et al published their experience including six rectal resections, three sigmoidectomies and a rectopexy [17]. Gangemi et al reported a mixed series of patients who underwent various procedures, including five ileocecal resections, a right hemicolectomy and a sigmoidectomy [7]. Caputo reported recently on three rectal resections using different setups [16].…”

“…Only the second report was included in this systematic review. Additionally, a sleeve resection and a subtotal gastrectomy were reported [7]. We performed a wedge gastric resection for a large benign tumour of the stomach.…”

“…Three robotic arms were used by all authors in cases of abdominal wall repair. Hiatal hernia repair as a separate procedure or as a part of fundoplication were described by Gangemi and Quijano in two cases [7,8]. We also performed three repairs of hiatal hernia: two of them with mesh reinforcement, and the third one combined with a Toupet fundoplication.…”