Step-by-step description of robot-assisted radical prostatectomy with the novel HUGO RAS robotic system using the Aalst-Technique

You have accessJournal of UrologyCME1 Apr 2023V10-04 STEP-BY-STEP DESCRIPTION OF ROBOT-ASSISTED RADICAL PROSTATECTOMY WITH THE NOVEL HUGO RAS ROBOTIC SYSTEM USING THE “AALST TECHNIQUE” Marco Paciotti, Carlo Andrea Bravi, Mottaran Angelo, Luigi Nocera, Luca Sarchi, Rui Farinha, Adele Piro, Maria Peraire Lores, Eleonora Balestrazzi, Federico Piramide, Frederiek D'Hondt, Geert De Naeyer, Aalst, Belgium, Ruben De Groote, and Alexandre Mottrie Marco PaciottiMarco Paciotti More articles by this author , Carlo Andrea BraviCarlo Andrea Bravi More articles by this author , Mottaran AngeloMottaran Angelo More articles by this author , Luigi NoceraLuigi Nocera More articles by this author , Luca SarchiLuca Sarchi More articles by this author , Rui FarinhaRui Farinha More articles by this author , Adele PiroAdele Piro More articles by this author , Maria Peraire LoresMaria Peraire Lores More articles by this author , Eleonora BalestrazziEleonora Balestrazzi More articles by this author , Federico PiramideFederico Piramide More articles by this author , Frederiek D'HondtFrederiek D'Hondt More articles by this author , Geert De NaeyerGeert De Naeyer More articles by this author , Aalst Aalst More articles by this author , Belgium Belgium More articles by this author , Ruben De GrooteRuben De Groote More articles by this author , and Alexandre MottrieAlexandre Mottrie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003328.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The HUGO™ RAS is a competitor for leadership in the field of robotic surgery. However, concerns remain about the ease of use of this device by new adopters. We performed the first robot-assisted radical prostatectomy (RARP) procedure in Europe with Hugo RAS. In this video, we described our surgical technique for bilateral nerve-sparing (NS) RARP performed using this novel platform. We also reported surgical setting and outcomes of our case series. METHODS: The procedure shown in the video was performed by an experienced robotic surgeon (AM) using HUGO RAS in March 2022. This robotic platform consists of four independent arm carts, novel design hand controllers and an open console. We described a RARP performed according the “Aalst technique”, including useful surgical tips. Moreover, we reported perioperative, pathological and short-term functional outcomes of consecutive patients affected by low- or intermediate-risk prostate cancer (PCa) who underwent NS RARP with HUGO RAS between February and October 2022 at our Center. RESULTS: Patients were in Trendelemburg position. One eleven-mm endoscope port was placed on the midline above the umbilicus, while other three 8 mm robotic ports were placed on a transversal line 5 cm below the optic port. Two laparoscopic ports were positioned in the right hemi-abdomen. Three arm carts were docked from the left of the operative bed, and one from the right. RARP was performed with a trans-peritoneal, anterior approach following validated metrics. Some of the specific characteristics our of technique, described in the video, are: sparing of the median umbilical ligament, postero-lateral approach to the bladder neck, antero-lateral release of the neurovascular bundles, dissection of the apex according to the “collar technique”, posterior muscolofascial reconstruction incorporated into urethrovesical anastomosis. Overall, 76 patients affected by low- or intermediate-risk PCa underwent RARP with HUGO RAS using this technique. In every case, all the steps of the procedure were completed. No intraoperative complication was recorded. Full outcomes are reported in the video. CONCLUSIONS: In this video, we described a step-by-step NS RARP performed according to our technique using the novel HUGO RAS. We provided useful tips to perform critical phases of the procedure. Experienced surgeons were able to easily perform all the surgeries with optimal perioperative, pathological, and functional outcomes. Therefore, we showed that surgical experience can be easily transferred to this novel platform. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e927 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Paciotti More articles by this author Carlo Andrea Bravi More articles by this author Mottaran Angelo More articles by this author Luigi Nocera More articles by this author Luca Sarchi More articles by this author Rui Farinha More articles by this author Adele Piro More articles by this author Maria Peraire Lores More articles by this author Eleonora Balestrazzi More articles by this author Federico Piramide More articles by this author Frederiek D'Hondt More articles by this author Geert De Naeyer More articles by this author Aalst More articles by this author Belgium More articles by this author Ruben De Groote More articles by this author Alexandre Mottrie More articles by this author Expand All Advertisement PDF downloadLoading ...