Background: Robotic-assisted surgery is the gold standard for performing radical prostatectomy (RARP), with new robotic devices such as HugoTMRAS gaining prominence worldwide. Objective: We report the surgical, perioperative, and early postoperative outcomes of RARP using HugoTMRAS. Design, setting, and participants: Between April 2022 and October 2023, we performed 132 procedures using the Montsouris technique with a four-robotic-arm configuration in patients with biopsy-proven prostate cancer (PCa). Outcome measures: We collected intraoperative and perioperative data during hospitalization, along with follow-up data at predefined postoperative intervals of 3 and 6 months. Results and limitations: Lymphadenectomy was performed in 25 procedures, with a bilateral nerve-sparing technique in 33 and a monolateral nerve-sparing technique in 33 cases. The mean total surgery time was 242 (±57) min, the mean console time was 124 (±48) min, and the mean docking time was 10 (±2) min. We identified 17 system errors related to robotic arm failures, 9 robotic instrument breakdowns, and 8 significant conflicts between robotic arms. One post-operative complication was classified as Clavien–Dindo 3b. None of the adverse events, whether singular or combined, increased the operative time. Positive margins (pR1) were found in 54 (40.9%) histological specimens, 37 (28.0%) of which were clinically significant. At 3 and 6 months post-surgery, the PSA levels were undetectable in 94.6% and 92.1% of patients, respectively. Social urinary continence was regained in 86% after 6 months. Limitations of our study include its observational monocentric case-series design and the short follow-up data for functional and oncological outcomes. Conclusions: Our initial experience highlights the reliability of the HugoTMRAS system in performing RARP. Additionally, we also list problems and solutions found in our daily work.
背景：机器人辅助手术是根治性前列腺切除术（RARP）的金标准，其中新型机器人设备如HugoTMRAS系统已在全球范围内获得广泛应用。目的：本研究旨在报告使用HugoTMRAS系统实施RARP的手术、围术期及早期术后结果。研究设计、场景与受试者：2022年4月至2023年10月期间，我们对经活检确诊的前列腺癌（PCa）患者采用四臂机器人配置的Montsouris技术完成了132例手术。观察指标：我们收集了住院期间的术中与围术期数据，并在术后3个月和6个月的预设时间点进行随访数据采集。结果与局限性：25例手术进行了淋巴结清扫，其中33例采用双侧神经保留技术，33例采用单侧神经保留技术。平均总手术时间为242（±57）分钟，平均操控台时间为124（±48）分钟，平均对接时间为10（±2）分钟。共发现17例与机械臂故障相关的系统错误、9例机器人器械损坏及8例机械臂间显著冲突。术后并发症中1例被归类为Clavien-Dindo 3b级。所有不良事件（无论是单独发生还是合并发生）均未导致手术时间延长。54例（40.9%）组织标本中发现切缘阳性（pR1），其中37例（28.0%）具有临床意义。术后3个月和6个月分别有94.6%和92.1%的患者检测不到前列腺特异性抗原（PSA）水平。术后6个月86%的患者恢复社会性尿控能力。本研究的局限性包括观察性单中心病例系列设计，以及功能和肿瘤学结果的随访数据时间较短。结论：我们的初步经验证实了HugoTMRAS系统实施RARP的可靠性，同时总结了日常工作中发现的问题及解决方案。
肿瘤(癌症)患者之家