Robotic transversus abdominis release using HUGO RAS system: our initial experience.

Abdominal wall repair HUGO RAS Hernia surgery Robotic surgery TAR Transversus abdominis release

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
08 May 2024
Historique:
received: 22 12 2023
accepted: 14 04 2024
medline: 9 5 2024
pubmed: 9 5 2024
entrez: 8 5 2024
Statut: aheadofprint

Résumé

Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®). All consecutive patients who underwent a rTAR in our institution were included. Three of the four arm carts of the HUGO RAS System were used at any given time. Each arm configuration was defined by our team in conjunction with Medtronic® personnel. rTAR was performed as previously described. Upon completion of the TAR on one side, a redocking process with different, mirrored arms angles was performed to continue with the contralateral TAR. Operative variables and early morbidity were recorded. Ten patients were included in this study. The median BMI was 31 (21-40.6) kg/m Robotic TAR utilizing the HUGO RAS system is a feasible and safe procedure. The adoption of this procedure on this novel platform for the treatment of complex abdominal wall hernias has been successful for our team.

Sections du résumé

BACKGROUND BACKGROUND
Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®).
METHODS METHODS
All consecutive patients who underwent a rTAR in our institution were included. Three of the four arm carts of the HUGO RAS System were used at any given time. Each arm configuration was defined by our team in conjunction with Medtronic® personnel. rTAR was performed as previously described. Upon completion of the TAR on one side, a redocking process with different, mirrored arms angles was performed to continue with the contralateral TAR. Operative variables and early morbidity were recorded.
RESULTS RESULTS
Ten patients were included in this study. The median BMI was 31 (21-40.6) kg/m
CONCLUSION CONCLUSIONS
Robotic TAR utilizing the HUGO RAS system is a feasible and safe procedure. The adoption of this procedure on this novel platform for the treatment of complex abdominal wall hernias has been successful for our team.

Identifiants

pubmed: 38719985
doi: 10.1007/s00464-024-10865-0
pii: 10.1007/s00464-024-10865-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Group H (2018) International guidelines for groin hernia management. Hernia 22:1–165
doi: 10.1007/s10029-017-1668-x
Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ (2012) Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg 204:709–716
doi: 10.1016/j.amjsurg.2012.02.008 pubmed: 22607741
Zolin SJ, Fafaj A, Krpata DM (2020) Transversus abdominis release (TAR): what are the real indications and where is the limit? Hernia 24:333–340
doi: 10.1007/s10029-020-02150-5 pubmed: 32152808
Guo AA, Isaac D, Jaraczewski L, Cobb WS, Carbonell AM, Warren JA (2023) Robotic repair of non-midline hernias. J Robot Surg 17:1021–1027
doi: 10.1007/s11701-022-01509-3 pubmed: 36463373
Munoz-Rodriguez JM, Lopez-Monclus J, San Miguel Mendez C, Perez-Flecha Gonzalez M, Robin-Valle de Lersundi A, Blázquez Hernando LA, Cuccurullo D, Garcia-Hernandez E, Sanchez-Turrión V, Garcia-Urena MA (2020) Outcomes of abdominal wall reconstruction in patients with the combination of complex midline and lateral incisional hernias. Surgery 168:532–542
doi: 10.1016/j.surg.2020.04.045 pubmed: 32527646
Wegdam JA, Thoolen JMM, Nienhuijs SW, de Bouvy N, de Vries Reilingh TS (2019) Systematic review of transversus abdominis release in complex abdominal wall reconstruction. Hernia 23:5–15
doi: 10.1007/s10029-018-1870-5 pubmed: 30539311
Cornette B, De Bacquer D, Berrevoet F (2018) Component separation technique for giant incisional hernia: a systematic review. Am J Surg 215:719–726
doi: 10.1016/j.amjsurg.2017.07.032 pubmed: 28811004
Halka JT, Vasyluk A, DeMare AM, Janczyk RJ, Iacco AA (2018) Robotic and hybrid robotic transversus abdominis release may be performed with low length of stay and wound morbidity. Am J Surg 215:462–465
doi: 10.1016/j.amjsurg.2017.10.053 pubmed: 29169820
Abdu R, Vasyluk A, Reddy N, Huang LC, Halka JT, DeMare A, Janczyk R, Iacco A (2021) Hybrid robotic transversus abdominis release versus open: propensity-matched analysis of 30-day outcomes. Hernia 25:1491–1497
doi: 10.1007/s10029-020-02249-9 pubmed: 32607651
Bittner JG, Alrefai S, Vy M, Mabe M, Del Prado PAR, Clingempeel NL (2018) Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair. Surg Endosc 32:727–734
doi: 10.1007/s00464-017-5729-0 pubmed: 28730275
Martin-Del-Campo LA, Weltz AS, Belyansky I, Novitsky YW (2018) Comparative analysis of perioperative outcomes of robotic versus open transversus abdominis release. Surg Endosc 32:840–845
doi: 10.1007/s00464-017-5752-1 pubmed: 28733746
Bracale U, Corcione F, Neola D, Castiglioni S, Cavallaro G, Stabilini C, Botteri E, Sodo M, Imperatore N, Peltrini R (2021) Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis. Hernia 25:1471–1480
doi: 10.1007/s10029-021-02487-5 pubmed: 34491460 pmcid: 8613152
Bianchi PP, Salaj A, Rocco B, Formisano G (2023) First worldwide report on Hugo RAS™ surgical platform in right and left colectomy. Updates Surg 75:775–780
doi: 10.1007/s13304-023-01489-5 pubmed: 36897505
Gueli Alletti S, Chiantera V, Arcuri G, Gioè A, Oliva R, Monterossi G, Fanfani F, Fagotti A, Scambia G (2022) Introducing the new surgical robot HUGO™ RAS: system description and docking settings for gynecological surgery. Front Oncol 12:898060
doi: 10.3389/fonc.2022.898060 pubmed: 35756633 pmcid: 9218341
Raffaelli M, Gallucci P, Voloudakis N, Pennestrì F, De Cicco R, Arcuri G, De Crea C, Bellantone R (2023) The new robotic platform Hugo™ RAS for lateral transabdominal adrenalectomy: a first world report of a series of five cases. Updates Surg 75:217–225
doi: 10.1007/s13304-022-01410-6 pubmed: 36333563
Quezada N, Grimoldi M, Besser N, Jacubovsky I, Achurra P, Crovari F (2022) Enhanced-view totally extraperitoneal (eTEP) approach for the treatment of abdominal wall hernias: mid-term results. Surg Endosc 36:632–639
doi: 10.1007/s00464-021-08330-3 pubmed: 33528665
Quezada N, Grimoldi M, Jacubovsky I, Besser N, Riveros S, Achurra P, Crovari F (2022) Midterm results of the open and minimally invasive transversus abdominis release technique for the treatment of abdominal wall hernias in an academic center. J Abdom Wall Surg 1:10407
doi: 10.3389/jaws.2022.10407 pubmed: 38314163 pmcid: 10831654
Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13:407–414
doi: 10.1007/s10029-009-0518-x pubmed: 19495920 pmcid: 2719726
Love MW, Warren JA, Davis S, Ewing JA, Hall AM, Cobb WS, Carbonell AM (2021) Computed tomography imaging in ventral hernia repair: can we predict the need for myofascial release? Hernia 25:471–477
doi: 10.1007/s10029-020-02181-y pubmed: 32277369
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213
doi: 10.1097/01.sla.0000133083.54934.ae pubmed: 15273542 pmcid: 1360123
Haskins IN, Horne CM, Krpata DM, Prabhu AS, Tastaldi L, Perez AJ, Rosenblatt S, Poulose BK, Rosen MJ (2018) A call for standardization of wound events reporting following ventral hernia repair. Hernia 22:729–736
doi: 10.1007/s10029-018-1748-6 pubmed: 29429064

Auteurs

Nicolas Quezada (N)

Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, 362 Diagonal Paraguay, 4th Floor, Office 410, Región Metropolitana, Santiago, Chile. nfquezad@uc.cl.

Maria Jesus Irarrazaval (MJ)

Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

David C Chen (DC)

Lichtenstein Amid Hernia Institute at University of California, Los Angeles, USA.

Milenko Grimoldi (M)

Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Fernando Pimentel (F)

Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, 362 Diagonal Paraguay, 4th Floor, Office 410, Región Metropolitana, Santiago, Chile.

Fernando Crovari (F)

Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, 362 Diagonal Paraguay, 4th Floor, Office 410, Región Metropolitana, Santiago, Chile.

Classifications MeSH