Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 5:10:1181790.
doi: 10.3389/fsurg.2023.1181790. eCollection 2023.

Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS

Marco Raffaelli  1   2 , Nikolaos Voloudakis  1   2 , Francesco Pennestrì  1   2 , Pierpaolo Gallucci  1 , Cristina Modesti  3   4 , Giulia Salvi  1   2 , Francesco Greco  1 , Luigi Ciccoritti  1
Affiliations

Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS

Marco Raffaelli et al. Front Surg. .

Abstract

Introduction: Robotic assisted surgery is a rapidly developing field of minimally invasive bariatric surgery in the last 20 years. Its wide diffusion has led to the development and standardization of robotic assisted approaches for bariatric operations. In this study, we present the first four Roux-en-Y Gastric Bypass (RYGB) operations performed with the new Hugo™ RAS system (Medtronic, Minneapolis, MN, USA).

Methods: In January and February 2023, 4 consecutive patients scheduled for minimal invasive Roux-en-Y-Bypass were selected and underwent the procedure robotic-assisted with the new platform. No exclusion criteria were applied.

Results: Four patients, two females and two males, underwent RYGB with a median BMI of 40 Kg/m2 (range: 36-46) and diabetes mellitus in two cases. The median docking time was 8 min (range: 7-8.5) and the median console time was 127.5 min (range: 95-150). A description of the operating theatre, robotic arms and docking setup is provided. Procedures were performed without intraoperative complications and no conversion to laparoscopy or open surgery was noted. No additional ports were needed to be placed. System's function and docking were uneventful. No early post-operative complications were observed.

Conclusions: Based on our initial experience, RYGB with the Hugo™ RAS system is feasible. This study provides the configurations necessary to perform RYGB with the Hugo™ RAS system as well as general information and insights from our preliminary experience.

Keywords: HUGO™ RAS; RYGB; Roux-en-Y Gastric Bypass; bariatric surgery; complications; docking setup; minimal invasive surgery; robotic surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Trocars position for RYGB with the Hugo™ RAS system in patient No 3. Camera, endoscope; RH, surgeon's right hand; LH, surgeon's left hand; Nathanson, liver retractor; Assistant; Reserve. (B) Following trocar and Nathanson retractor placement in patient No. 2.
Figure 2
Figure 2
(A) Operative room settings, positions of platform's components and surgical team members during RYGB. Description of arms docking and tilt angles. (B) Modifications after first operation. Description of arms docking and tilt angles. Further small changes can be performed to optimally match patient's body type.
Figure 3
Figure 3
(A) Intraoperative image during the docking. (B) Intraoperative image exhibiting the anesthesiologist's position. (C) Intraoperative image exhibiting the assistant's position. (D) Intraoperative image exhibiting the console position during surgery.
See this image and copyright information in PMC

References

    1. Pineda E, Sanchez-Romero LM, Brown M, Jaccard A, Jewell J, Galea G, et al. Forecasting future trends in obesity across Europe: the value of improving surveillance. Obes Facts. (2018) 11:360–71. 10.1159/000492115 - DOI - PMC - PubMed
    1. Ozsoy Z, Demir E. Which bariatric procedure is the most popular in the world? A bibliometric comparison. Obes Surg. (2018) 28:2339–52. 10.1007/S11695-018-3163-6/TABLES/4 - DOI - PubMed
    1. Aiolfi A, Tornese S, Bonitta G, Rausa E, Micheletto G, Bona D. Roux-en-Y Gastric Bypass: systematic review and Bayesian network meta-analysis comparing open, laparoscopic, and robotic approach. Surg Obes Relat Dis. (2019) 15:985–94. 10.1016/J.SOARD.2019.03.006 - DOI - PubMed
    1. Gagner M, Gumbs AA, Milone L, Yung E, Goldenberg L, Pomp A. Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m(2)). Surg Today. (2008) 38:399–403. 10.1007/S00595-007-3645-Y - DOI - PubMed
    1. Parikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic bariatric surgery in super-obese patients (BMI > 50) is safe and effective: a review of 332 patients. Obes Surg. (2005) 15:858–63. 10.1381/0960892054222632 - DOI - PubMed