PDF(Pubmed)
Abstract：
Background: The Hugo™ Robot-Assisted Surgery (RAS) system is a new cutting-edge robotic platform designed for clinical applications. Nevertheless, its application for cystic renal tumors has not yet been thoroughly investigated. In this context, we present an initial series of Robot-Assisted Partial Nephrectomy (RAPN) procedures carried out using the Hugo™ RAS system for cystic renal masses. Methods: Between October 2022 and January 2024, twenty-seven RAPN procedures for renal tumors were performed at Fondazione Policlinico Universitario Campus Bio-Medico. Our prospective board-approved dataset was queried for \"cystic features\" (n = 12). Perioperative data were collected. The eGFR was calculated according to the CKD-EPI formula. Post-operative complications were reported according to the Clavien-Dindo classification. Computed tomography (CT) scans for follow-up were performed according to the EAU guidelines. Trifecta was defined as the coexistence of negative surgical margin status, no Clavien-Dindo grade ≥ 3 complications, and eGFR decline ≤ 30%. Results: All the patients successfully underwent RAPN without the need for conversion or additional port placement. The median docking and console time were 5.5 (IQR, 4-6) and 79.5 min (IQR, 58-91 min), respectively. No intraoperative complications occurred, as well as clashes between instruments or with the bedside assistant. Two minor postoperative complications were recorded (Clavien-Dindo II). At discharge, serum creatinine and eGFR were comparable to preoperative values. Only one patient (8.4%) displayed positive surgical margins. The rate of trifecta achievement was 91.7%. Conclusions: RAPN for cystic renal masses using the novel Hugo™ RAS system can be safely and effectively performed. This robotic system provided satisfactory peri-operative outcomes, preserving renal function and displaying low postoperative complications and a high trifecta rate achievement.
摘要：
背景：Hugo™机器人辅助手术（RAS）系统是一种专为临床应用而设计的新型尖端机器人平台。然而，其在囊性肾肿瘤中的应用尚未得到彻底研究。在这种情况下，我们介绍了使用Hugo™RAS系统治疗囊性肾肿块的机器人辅助部分肾切除术(RAPN)的初步系列.方法：在2022年10月至2024年1月之间，在FondazionePoliclinico大学校园Bio-Medico进行了27例肾肿瘤的RAPN手术。我们的前瞻性委员会批准的数据集被查询为“囊性特征”(n=12)。收集围手术期数据。根据CKD-EPI公式计算eGFR。根据Clavien-Dindo分类报告术后并发症。根据EAU指南进行计算机断层扫描（CT）扫描以进行随访。Trifecta被定义为阴性手术边缘状态的共存，无Clavien-Dindo≥3级并发症，eGFR下降≤30%。结果：所有患者均成功接受了RAPN，无需转换或额外的端口放置。对接和控制台时间中位数为5.5(IQR，4-6）和79.5分钟（IQR，58-91分钟)，分别。术中无并发症发生,以及乐器之间或与床边助手之间的冲突。记录了两个轻微的术后并发症（Clavien-DindoII）。出院时,血清肌酐和eGFR与术前值相当.只有一名患者（8.4％）显示出积极的手术切缘。三联成功率为91.7%。结论：使用新型Hugo™RAS系统对囊性肾肿块进行RPN可以安全有效地进行。这个机器人系统提供了令人满意的围手术期结果，保留肾功能，术后并发症低，三联率高。
