Alberto Breda and Carla Perón during the 19th ERUS Congress.
The robotic surgery continues to advance by leaps and bounds within the field of Health, and one of its greatest innovative exponents is the robot Hugo. The latest generation project developed by medtronic, which strengthened its position at the 19th Congress of Robotic Urology in Barcelona (ERUS), is a key exponent in the scenario of the world robotic surgery as one of the most advanced, offering a wide variety of interventions thanks to the incorporation of artificial intelligencea open console and one modular structure.
The Hugo robot is presented at the 19th ERUS Congress
What role has the Hugo robot played in this event and what feedback have you received from the professionals who have been interested in it?
Carla Peron, Vice President of Clinical Research and Medical Science of Surgical Innovations and Robotics at Medtronic: From Medtronic we are very happy to be at the Robotic Surgery and Urology Congress in Barcelona. It is the first specialty for which we had the opportunity to secure regulatory approval. A live demonstration of seven different procedures was carried out with very interesting feedback from the surgeons. In particular, the 3D ability of the system that allows us to open the console and the storage chamber, in addition to the flexibility of the four independent arms, which can be positioned according to the needs of each procedure. Partial or total prostatectomies and nephrectomies were performed, giving the opportunity to know all its benefits. It has been a very important step for Medtronic and for the entire urological community in Europe.
Carla Perón: “Hugo allows us to perform partial or total prostatectomies and nephrectomies”
Alberto Breda, head of the Oncological Urology Unit of the Puigvert Foundation and current president of the Robotic Surgery Section of the European Society of Urology (EAU): In 2022, ERUS has decided to teach live surgeries worldwide for the first time with Hugo. We’ve had ten of the 38 done, 30 percent have been done with this robot. The feedback has been more than positive, people wanted to see this new system and get an idea of what the vision is like, which is superlative. There are obviously improvements to be made, it is the first generation of the robot and more will come in the future.
In the daily life of the doctor, what is the greatest contribution of the Hugo robot?
peron: The robotic system has great potential to assist specialists in evasive surgery, since it allows the search for a unique technique for surgical procedures in the entire abdomen. The four independent arms and the open console allow surgeons to seek the best technique to minimize evasion of the surgical procedure in Gynecology, Urology and general surgery.
Alberto Breda: “When there are complex tumors such as kidney or prostate, Hugo’s precision offers a better functional result”
breda: The Hugo robot has a new modular system compared to what we already had available on the market. It has four modules that help the surgeon to connect each arm in a unique way, and therefore use them independently. It has a great advantage for the urologist in general, which is the open console. He has trained his whole life in laparoscopic surgery, he has a direct vision much more similar to what a closed console can offer. For me it is an important advantage, since it allows me to interact directly with the assistant and the instrumentalists on the table. It is very safe for both the surgeon and the patient.
As for Hugo’s digital system, how does it help the professional in the intervention?
peron: Our Hugo robotic system comes with a digital ecosystem, which allows professionals who use it to record and upload annotated and organized videos to the cloud so that they can evaluate it immediately after the surgical procedure. This allows surgeons to improve technique, apply new concepts and use Hugo at its best. All this makes it easier to involve, in addition to the surgeons themselves, other specialists from more hospitals around the world. The integration of information is vital to support the use of technology.
What benefits does the robotic arm have to intervene in a complex tumor?
breda: Robotic surgery to intervene complex tumors has undoubted advantages such as precision, the ability to take the tremor out of the surgeon’s hands. When there are complex tumors such as kidney or prostate, obviously this precision offers a better functional or oncological result. Consequently, there is an improvement for our patients.
What level of detail does the 3D open screen allow in Hugo?
breda: The 3D screen allows for an exquisite level of detail. It’s not just 3D, but it’s 3D 4K HD. It means that this allows an increased vision and with a maximum precision and definition, almost superior to what the human eye can perceive.
This Medtronic technology has four modular arms. What practical applications does it have when intervening on a patient?
peron: The robotic system has been conceived with four independent arms that allows us to use it in a very flexible way. Depending on the procedure they can be positioned around the patient. With this, it allows the four quadrants of binomial surgery to be activated; If you are undergoing a pelvic procedure, it will go to the pelvis, and if it is a general surgery, it will go to the upper or lower abdomen. It is a flexible system that allows us to plan the procedure according to the patient’s needs.
“The Hugo robot is already approved for Gynecology and Urology; and has just achieved approval for general surgery in Europe and Canada”
Beyond its applications in the field of Urology, in what other interventions can the technology be applied?
peron: Hugo has been designed for all abdominal and thoracic procedures, but we already have regulatory approval for Gynecology and Urology, and we have just achieved approval for general surgery in Europe and Canada.
Regarding cost effectiveness, what results does the Hugo robot offer?
peron: The penetration of the robotic system is far below in the world. This is one of the great barriers aligned with cost. Hugo has been designed with this in mind and with the aim of ensuring that the use of the system bears the costs in the best possible way for the benefit of the patient. The four independent arms allow the use of instruments only necessary for the procedure. We want to bring a system that has cost-effectiveness in mind.
As for the training required by the healthcare professional to use it, is it complex? How is this formative process?
breda: Like all new technologies and techniques, Hugo needs training. Currently the training takes place in collaborating centers around the world, including the ORSI Academy of the OLV Hospital, in Belgium, and IRCAD, in France, where the teams that acquire Hugo are trained. Not only the surgeons learn, but also the surgical, nursing and anesthesia teams. It is a team effort, not only surgeons are trained. Assistants and instrumentalists need training.
A professional with or without robotic experience is very different. If you already have it with other surgical robots, the transition to Hugo is very easy. If you do not have skills, there is no transition, you must learn from scratch. For surgeons who have always had surgical robots, in two days of training at the OLV and one day of theoretical study at the hospital, the transition can last between three or four sessions to apply this technology to humans.
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