Implementation and outcomes of HugoTM RAS System in robotic-assisted radical prostatectomy

ABSTRACT Background The results and benefits of Robotic-assisted Radical Prostatectomy (RARP) are already established in the literature. However, new robotic platforms have been released recently in the market and their outcomes are still unknown. In this scenario, our objective is to describe our experience implementing the HugoTM RAS robot and report the clinical data of patients who underwent Robotic-assisted Radical Prostatectomy. Material and Methods We retrospectively analyzed fifteen consecutive patients who underwent RARP with HugoTM RAS System (Medtronic, Minneapolis, USA) from June to October 2021. The patients underwent transperitoneal RARP on lithotomy position, using six trocars (4 robotic trocars and 2 for the assistant). We reported the clinical feasibility and safety of this platform, assessing perioperative data, including complications and early outcomes. Continuous variables were reported as median and interquartile ranges, categorical variables as frequencies and proportions. Results and Limitations All procedures were safe and feasible with no major complications or conversion. Median operative time was 235 minutes (213-271), and median estimated blood loss was 300ml (100-310). Positive surgical margins were reported in 5 patients (33%). The median hospitalization time was 2 days (2-2), and the median time to remove the foley was 7 days (7-7). On the first appointment four weeks after surgery, all patients had undetectable PSA values, and 61% were continent. Conclusions We described preliminary results with safe and feasible procedures performed with HugoTM RAS System robotic platform. The surgeries were successfully executed with acceptable perioperative outcomes, without conversions or major complications. However, as this technology is very recent, further studies with a long-term follow-up are awaited to access postoperative functional and oncological outcomes.

Uréter ileal revisitado / Ileal ureter revisited

Introducción: El reemplazo del uréter por un asa desfuncionalizada de íleon fue reportado por primera vez hace más de cien años. En las últimas décadas sus indicaciones y el conocimiento de las técnicas para su utilización se han ampliado enormemente. Material y Método: Se efectúa una revisión de las indicaciones, técnica quirúrgica complicaciones del uréter ileal, a partir del reporte de tres casos clínicos de uso de un segmento de íleon como reemplazo ureteral. Resultados: Entre el año 2001 y 2003, tres pacientes (promedio 28 años de edad) recibieron un segmento de íleon como subtitulo de un uréter severamente dañado. Durante el período de seguimiento (promedio 22 meses) no se objetivaron complicaciones graves derivadas del procedimiento, la necesidad de realizar una nueva diversión urinaria, evidencia de deterioro renal o mortalidad. Conclusiones: El intestino constituye un recurso indiscutible al que puede recurrir el urólogo en su práctica quirúrgica reconstructiva. El uso de un segmento desfuncionalizado de íleon como reemplazo de un uréter dañado, proporciona una alternativa terapéutica segura y reproducible, de proveer el riñón de un drenaje a baja presión, no obstructivo, que preserve la función renal.