Robotic adrenalectomy: comparison of DaVinci, HUGO™-RAS and Versius^® platforms-a preliminary retrospective analysis

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/m² 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.