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Robotic posterior retroperitoneoscopic adrenalectomy: initial experience with Hugo™ RAS system
Martí Manyalich-Blasi1, David Saavedra-Pérez2, Leidy M Fajardo Guzman3
1Service of General and Digestive Surgery, Institute Clinic of Digestive and Metabolic Diseases (ICMDM), Hospital Clinic de Barcelona, Universitat de Barcelona, Villarroel 170, Escalera 10, Planta 3., 08036, Barcelona, Spain. Manyalich@clinic.cat.
Robotic retroperitoneal adrenalectomy (RRA) using the RAS Hugo™ platform is feasible for selected patients, demonstrating good outcomes and short hospital stays. Further evaluation is needed for operative time and team expertise.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Urology and Endocrinology
Background:
- Robot-assisted surgery enhances visualization and instrument dexterity for minimally invasive procedures.
- Robotic retroperitoneal adrenalectomy (RRA) is a developing application for robotic surgical systems.
Purpose of the Study:
- To evaluate the initial outcomes of robotic retroperitoneal adrenalectomy (RRA) using the RAS Hugo™ platform.
- To assess the feasibility and safety of RRA in the first 10 consecutive cases.
Main Methods:
- Ten patients underwent RRA in the prone position between July 2023 and February 2024.
- Standard endoscopic techniques, high-energy sealing for adrenal vein, and protective bags for specimen extraction were used.
- Patients had suspected primary hyperaldosteronism or Cushing's syndrome, with median age 58 and BMI 28.5 kg/m².
Main Results:
- Median operative time was 124.5 minutes, with one conversion to an endoscopic approach due to pyelonephritis.
- No postoperative complications were observed, and the median hospital stay was 1 day.
- Tumor characteristics and patient demographics (ASA II/III) were recorded, with lesions equally distributed between adrenal glands.
Conclusions:
- Robotic retroperitoneal adrenalectomy (RRA) is feasible in selected patients, offering improved visualization and precision.
- Considerations for RRA include operative time and the necessity of experienced surgical teams.
- The RAS Hugo™ platform shows promise for adrenalectomy, but further studies are warranted.
