Retroperitoneal Renal Surgery with the Hugo™ RAS System: Feasibility, Setting and Perioperative Outcomes of the First...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Retroperitoneal renal surgery offers advantages but requires specialized techniques.
• The Hugo™ RAS system is a novel robotic platform for minimally invasive procedures.

Purpose of the Study:

• To evaluate the feasibility, safety, and reproducibility of retroperitoneal renal surgery using the Hugo™ RAS system.
• To describe the surgical setup, docking strategy, and perioperative outcomes for this specific application.

Main Methods:

• A series of 30 retroperitoneal renal surgeries (15 partial nephrectomies, 15 pyeloplasties) were performed using the Hugo™ RAS system.
• A standardized retroperitoneal access and a three-arm trocar configuration with predefined docking angles were employed.
• Feasibility was defined as successful completion without conversion to open or transperitoneal surgery; perioperative data were prospectively collected.

Main Results:

• All 30 procedures were completed successfully without conversion, demonstrating feasibility.
• Robot-assisted partial nephrectomy (RAPN) had a median docking time of 5 minutes and estimated blood loss of 200 mL, with 20% experiencing Clavien-Dindo grade II complications.
• Robot-assisted pyeloplasty had a median operative time of 150 minutes and estimated blood loss of 70 mL, with 7% experiencing a grade II complication. Renal function remained stable.

Conclusions:

• Retroperitoneal renal surgery with the Hugo™ RAS system is feasible, safe, and reproducible.
• A standardized docking and port configuration is crucial for successful outcomes.
• This approach offers a viable option for complex renal procedures.