Robotic Heller's myotomy using the new Hugo™ RAS system: first worldwide report

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Robotic Surgery

Background:

• Achalasia is a rare esophageal motility disorder characterized by lower esophageal sphincter (LES) failure.
• Robotic Heller's myotomy (RHM) is an advanced surgical treatment for achalasia.
• The novel Hugo RAS™ system presents a unique modular design for robotic surgery.

Purpose of the Study:

• To present the first worldwide series of patients undergoing RHM using the Hugo RAS™ platform.
• To propose optimal operating configurations for the Hugo RAS™ system in RHM.
• To evaluate the feasibility and initial outcomes of RHM with the Hugo RAS™ system.

Main Methods:

• Ten consecutive achalasia patients underwent RHM utilizing the Hugo RAS™ system.
• Prospective data collection included patient demographics, clinical scores (Eckardt), and pre-operative manometry.
• Docking and total operative times were recorded for each procedure.

Main Results:

• Ten patients (median age 42.5, 60% female) with achalasia types 1 and 2 underwent RHM.
• Median docking time was 10 minutes, and overall operative time was 129.5 minutes.
• The peri-operative course was uneventful for most patients, with discharge on post-operative day 2.

Conclusions:

• The Hugo RAS™ system is suitable for robotic Heller myotomy, offering improved maneuverability and ergonomics.
• Initial operative and clinical results are comparable to existing robotic systems.
• Further experience is required to fully leverage the advantages of the Hugo RAS™ system's modular design.