Docking optimization for right hemicolectomy with complete mesocolon excision (CME) with HUGO™ robotic system: the "Gemelli configuration".

BACKGROUND

Laparoscopic complete mesocolic excision (CME) during right hemicolectomy is a complex procedure. The introduction of robotic-assisted surgery has improved dexterity, three-dimensional (3D) visualization, and surgeon ergonomics. However, for the modular HUGO™ Robotic-Assisted Surgery (RAS) system, experience with CME is limited, and the standard docking configuration for right hemicolectomy presents many disadvantages.

METHODS

We developed a modified docking strategy (the "Gemelli configuration") specifically designed to optimize robotic right hemicolectomy with CME using the HUGO™ RAS platform. This setup provides improved instruments triangulation and reduced robotic arm interference. The technique was applied in two consecutive cases.

RESULTS

Both procedures were completed fully robotically with a single docking, without arm collisions or the need for repositioning. Compared with the standard setup, the Gemelli configuration yields enhanced visualization of the mesenteric axis and vascular pedicles and improved access to the transverse mesocolon.

CONCLUSIONS

The "Gemelli configuration" represents a safe, simple, and reproducible docking strategy for performing right hemicolectomy with CME using the HUGO™ RAS system. Further validation in larger patient series is warranted to confirm these preliminary benefits.