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. 2025 Sep 18.
doi: 10.1007/s13304-025-02414-8. Online ahead of print.

Robotic adrenalectomy: comparison of DaVinci, HUGO™-RAS and Versius® platforms-a preliminary retrospective analysis

Priscilla Francesca Procopio #  1   2 , Francesco Pennestrì #  3   4 , Pierpaolo Gallucci  1 , Antonio Laurino  1 , Annamaria Martullo  1   2 , Carmela De Crea  1   2 , Marco Raffaelli  1   2
Affiliations

Robotic adrenalectomy: comparison of DaVinci, HUGO™-RAS and Versius® platforms-a preliminary retrospective analysis

Priscilla Francesca Procopio et al. Updates Surg. .

Abstract

Robot-assisted adrenalectomy (RAA) has emerged as an advantageous approach in challenging cases and suspicious lesions, although high costs represent the main drawback to its broader application. Besides Da-Vinci, new platforms have been recently launched on the market and need to be validated in clinical practice. DaVinci, HUGO™-RAS and Versius® platforms were introduced in our center in 2012, 2022, and 2024, respectively. We aimed to compare the perioperative outcomes of these robotic platforms. Among 730 adrenalectomies (2012-2024), 149 (20.4%) RAAs were performed. All procedures performed by means of HUGO™-RAS and Versius® platforms were compared with similar procedures (in terms of patient's and lesion's features) performed with the DaVinci technology in the same period (2022-2024). Ten patients were included in each group. Patients' and lesions' features were similar. Median BMI and lesions' size were 27.9, 24.9, and 26.1 kg/m2 and 42.5, 42.5, and 32.5 mm in DaVinci, HUGO™-RAS, and Versius® groups, respectively (p = 0.360, p = 0.236). The groups were comparable for docking time, console time, and operative time (5 vs. 5 vs. 7 min, p = 0.059, 58.5 vs. 58 vs. 39 min, p = 0.393, 109.5 vs. 110.5 vs. 104.1 min, p = 0.668, respectively). No conversion or perioperative complications were registered. Postoperative hospital stays were similar (2 days in all groups, p = 0.629). RAA, whatever platform is used, confirmed to be a safe and effective approach, potentially expanding indications for minimally invasive adrenalectomy. Even though new platforms have been applied in less demanding cases in our learning curve phase, the introduction of new different platforms may lead to a costs reduction, thus to a broader diffusion of RAA.

Keywords: DaVinci; HUGO™-RAS; Operative time; Postoperative complications; Robotic adrenalectomy; Versius®.

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Conflict of interest statement

Declarations. Conflict of interest: Marco Raffaelli has a consultant agreement with Medtronic, AB Medica, and Intuitive Surgical. Priscilla Francesca Procopio, Francesco Pennestrì, and Antonio Laurino have a consultant agreement with Medtronic. Carmela De Crea and Annamaria Martullo declare no conflicts of interest. Compliance with ethical standards: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Research involving human participants and/or animals: This article does not contain any studies with animals performed by any of the authors. Informed consent: Informed consent was obtained from all individual participants for whom identifying information is included in this article.

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