MP67-08: Surgical Outcomes of Robot-Assisted Radical Prostatectomy with The Novel "HUGO" Robotic System: Initial 100 Cases Performed at a Tertiary Referral Robotic Center Center

Sunday, April 30, 2023

3:30 PM – 5:30 PM CST

Location: S403

Poster Presenter(s)

MP

Maria Peraire Lores

Introduction: HUGO Robot-Assisted Surgery (RAS) system (Medtronic©, USA) has recently received CE mark approval for urological procedures. Herein, we described clinical outcomes of the first case series of robot-assisted radical prostatectomy (RARP) with the HUGO RAS system.

Methods: We analyzed data of 107 patients who received RARP ± extended pelvic lymph-node dissection (ePLND) at OLV hospital (Aalst, Belgium). All procedures were performed by experienced robotic surgeons. We described peri-, post-operative and functional outcomes. Final pathology results were available for 100 patients. Continence was defined as the use of no/one safety pad.

Results: Median (interquartile range [IQR]) age was 65 (60, 70) years. Median (IQR) preoperative PSA level was 7.8 (5.6, 10.2) ng/ml. A total of 36 (34%) patients had International Society of Urologic Pathology (ISUP) group 3-5 tumors on prostate biopsy. On preoperative MRI, median (IQR) prostate volume was 40 (32, 55) ml, and twenty patients (19%) had a suspicion of extra-prostatic disease. All twelve validated steps of the procedure were completed, with no need for conversion or for additional ports placement. 28 (26%) patients received an ePLND. No intraoperative complication was recorded. Median (IQR) operative and console time were 180 (140, 200) and 150 (110, 180) minutes, respectively. Median (IQR) estimated blood loss was 450 (250, 550) ml. Median (IQR) postoperative day of removal of urethral catheter was 2 (2, 2) days. After surgery, one patient experienced an acute urinary retention that was treated with re-catheterization. Two patients had a Clavien-Dindo =2 postoperative complications. Median (IQR) length of stay was 3 (3, 4) days. On final pathology, 42 (42%) and 28 (28%) patients had ISUP group 3-5 tumors and evidence of extraprostatic extension, respectively. A total of 8 (8%) patients had positive surgical margins. A total of 77 and 45 patients had available data on urinary continence recovery at one and three months after surgery, respectively. One month after surgery, 49/77 (64%) patients were continent, whereas 41/45 (91%) recovered urinary continence 3 months after surgery.

Conclusions: In this clinical investigation, we showed that RARP performed with the novel HUGO RAS system achieves optimal oncologic and functional outcomes. Further, multi-centric data are awaited to confirm these findings at longer follow-up, with respect to biochemical recurrence and erectile function recovery after surgery. SOURCE OF

Funding: None