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966 First robotic radical trachelectomy for cervical cancer using HugoTM RAS platform
  1. Renato Moretti-Marques1,
  2. Vanessa Alvarenga-Bezerra1,
  3. Pedro Ernesto De Cillo1,
  4. Danielle Yumi Akaishi1,
  5. Jeancarllo De Souza Silva2 and
  6. Nam Jin Kim1
  1. 1Hospital Israelita Albert Einstein, São Paulo, Brazil
  2. 2Universidade Estadual do Amazonas, Manaus, Brazil

Abstract

Introduction/Background The diagnosis of cervical cancer occurs in 38% of patients up to 45 years old. With the trend towards postponing reproductive desire, fertility preservation becomes more relevant within the range of oncological treatments.

Radical trachelectomy is a well established treatment with similar oncological outcomes then radical hysterectomy - for tumors smaller than 2 cm, confined to the cervix and with negative lymph nodes. Furthermore, current evidence indicates similar oncological outcomes and higher pregnancy rates when the robotic platform is used.

In 2022, the HugoTMRAS System (Medtronic, Minneapolis-USA) was launched, providing an alternative to the DaVinci(Intuitive®) platform. The purpose of this video-article is to describe the technical differences involved in the first radical trachelectomy with this new robotic system, demonstrating its capacity in assisting complex gynecologic oncological surgeries.

Methodology Case Description: Patient is 36-year-old, nulligravida, with type C cervical adenocarcinoma with 5mm invasion depth, no lymphovascular invasion (LVI), and surgical clear margins, FIGO 2021 IA2. Complementary workup did not evidenced residual disease. A robot-assisted radical trachelectomy with bilateral sentinel lymph nodes dissection was performed.

Results Discussion: Radical trachelectomy is among the most complex gynecological oncological surgeries, considering the care for preserving neural and urinary structures, extensive parametrial dissection, and dynamic presentations during the procedure.

Initial experience with HugoTM RAS in our institution highlighted technical and logistical differences between the two platforms, which entail potential benefits and drawbacks compared to the DaVinci System.

The main differences are the independent robotic arms and open console. In the video, other key point differences will be highlighted and unrivaled.

Conclusion From the early experience with the Hugo RAS™, it appears to be a safe robotic platform for major gynecologic oncology procedures, being a good addition to the existing surgical robots arsenal.

Disclosures There are no disclosures.

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