Presentation Information
[SY5-3]A novel technique; Single-Incision Plus One Robot-assisted Surgery（SIPORS）for colorectal cancer by Hugo RAS System
*Takehito Yamamoto1, Yoshiro Itatani1, Ryosuke Okamura1, Haruku Fujita1, Shingo Ochi1, Ryuhei Aoyama1, Yu Yoshida1, Masahiro Maeda1, Keiko Kasahara1, Nobuaki Hoshino1, Kazutaka Obama1 (1. Department of Surgery, Kyoto University, Japan)
Background
Given the high cost of robot-assisted surgery, surgeons must maximize benefits beyond those of conventional minimally invasive approaches. In April 2025, we have developed a novel technique, single-incision plus one robot-assisted surgery (SIPORS) by Hugo™ RAS system (hereafter, Hugo)(Ann Coloproctol, 2025, Dis Colon Rectum, 2026).
Patients and Methods
Among patients who underwent colorectal cancer surgery using Hugo at our institution between April 2024 and April 2026, we retrospectively analyzed short-term outcomes of those treated with SIPORS and describe the surgical technique.
Surgical Technique
For right-sided colon cancer, a 4-cm Pfannenstiel incision is created, through which a wound protector and surgical glove are applied. An 11-mm camera trocar and two 8-mm robotic trocars are inserted via this incision, accommodating a 30-degree oblique camera and two graspers. One additional 8-mm robotic trocar is placed in the left upper abdomen. Monopolar shears are introduced via this additional port, ensuring sufficient freedom of the right-hand robotic arm. For left-sided colon cancer, a line-symmetric port configuration is used, whereas for sigmoid colon and rectal cancer, a point-symmetric configuration is adopted. In APR, the small incision is placed at the stoma site to further reduce invasiveness.
Results
Of 122 patients who underwent surgery using Hugo, 24 underwent SIPORS. Procedures included ICR (n=2), RHC (n=7), transverse colectomy (n=1), LHC (n=1), sigmoidectomy (n=1), HAR (n=3), (ultra-)LAR (n=7), and APR (n=2). Median operative time was 242 [187–316] min for colon surgery and 310 [172–462] min for rectal surgery. The number of harvested lymph nodes was 25 [12–48] and 20 [11–25], respectively. One Grade II complication (urinary tract infection) occurred in rectal surgery, and one Grade III complication (ileus) in colon surgery. Median postoperative hospital stay was 11 [7–14] days and 13 [10–19] days, respectively (all values are median [range]).
Conclusions
SIPORS can be a safe and feasible surgical approach.
Given the high cost of robot-assisted surgery, surgeons must maximize benefits beyond those of conventional minimally invasive approaches. In April 2025, we have developed a novel technique, single-incision plus one robot-assisted surgery (SIPORS) by Hugo™ RAS system (hereafter, Hugo)(Ann Coloproctol, 2025, Dis Colon Rectum, 2026).
Patients and Methods
Among patients who underwent colorectal cancer surgery using Hugo at our institution between April 2024 and April 2026, we retrospectively analyzed short-term outcomes of those treated with SIPORS and describe the surgical technique.
Surgical Technique
For right-sided colon cancer, a 4-cm Pfannenstiel incision is created, through which a wound protector and surgical glove are applied. An 11-mm camera trocar and two 8-mm robotic trocars are inserted via this incision, accommodating a 30-degree oblique camera and two graspers. One additional 8-mm robotic trocar is placed in the left upper abdomen. Monopolar shears are introduced via this additional port, ensuring sufficient freedom of the right-hand robotic arm. For left-sided colon cancer, a line-symmetric port configuration is used, whereas for sigmoid colon and rectal cancer, a point-symmetric configuration is adopted. In APR, the small incision is placed at the stoma site to further reduce invasiveness.
Results
Of 122 patients who underwent surgery using Hugo, 24 underwent SIPORS. Procedures included ICR (n=2), RHC (n=7), transverse colectomy (n=1), LHC (n=1), sigmoidectomy (n=1), HAR (n=3), (ultra-)LAR (n=7), and APR (n=2). Median operative time was 242 [187–316] min for colon surgery and 310 [172–462] min for rectal surgery. The number of harvested lymph nodes was 25 [12–48] and 20 [11–25], respectively. One Grade II complication (urinary tract infection) occurred in rectal surgery, and one Grade III complication (ileus) in colon surgery. Median postoperative hospital stay was 11 [7–14] days and 13 [10–19] days, respectively (all values are median [range]).
Conclusions
SIPORS can be a safe and feasible surgical approach.