Implementation and outcomes of HugoTM RAS System in robotic-assisted radical prostatectomy

Abstract

Background The results and benefits of Robotic-assisted Radical Prostatectomy (RARP) are already established in the literature. However, new robotic platforms have been released recently in the market and their outcomes are still unknown. In this scenario, our objective is to describe our experience implementing the Hugo TM RAS robot and report the clinical data of patients who underwent Robotic-assisted Radical Prostatectomy. Material and Methods We retrospectively analyzed fifteen consecutive patients who underwent RARP with Hugo TM RAS System (Medtronic, Minneapolis, USA) from June to October 2021. The patients underwent transperitoneal RARP on lithotomy position, using six trocars (4 robotic trocars and 2 for the assistant). We reported the clinical feasibility and safety of this platform, assessing perioperative data, including complications and early outcomes. Continuous variables were reported as median and interquartile ranges, categorical variables as frequencies and proportions. Results and Limitations All procedures were safe and feasible with no major complications or conversion. Median operative time was 235 minutes (213-271), and median estimated blood loss was 300ml (100-310). Positive surgical margins were reported in 5 patients (33%). The median hospitalization time was 2 days (2-2), and the median time to remove the foley was 7 days (7-7). On the first appointment four weeks after surgery, all patients had undetectable PSA values, and 61% were continent. Conclusions We described preliminary results with safe and feasible procedures performed with Hugo TM RAS System robotic platform. The surgeries were successfully executed with acceptable perioperative outcomes, without conversions or major complications. However, as this technology is very recent, further studies with a long-term follow-up are awaited to access postoperative functional and oncological outcomes.

Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms

“…Although the experiences from the DV system could help early adaptation to the Hugo RAS system [ 22 ], surgeons still needed time to become accustomed to some different devices on the Hugo RAS system, such as hand controls and arm carts’ degrees of freedom [ 25 ]. We mentioned that the vesicourethral anastomosis time was longer in the Hugo RAS group in this study.…”

Intraoperative Performance of DaVinci Versus Hugo RAS During Radical Prostatectomy: Focus on Timing, Malfunctioning, Complications, and User Satisfaction in 100 Consecutive Cases (the COMPAR-P Trial)

“…Still, we suggest that for the implementation of new technologies, mandatory laboratory-based training to proficiency should be considered, prioritizing patient safety over accepting such phenomena as reflective of real-life conditions. Other groups have published their very initial experience with H-RARP [15] , [16] , [17] , but only Ou et al [18] described the need to find optimization in ports’ placement and docking. The authors observed some intraoperative issues that slowed the procedure flow.…”

State of the Art in Robotic Surgery with Hugo RAS System: Feasibility, Safety and Clinical Applications

“…The Hugo TM RAS system has been primarily used in urological procedures such as RARPs and RAPNs [ 3 , 4 , 5 , 8 , 9 , 10 , 11 ]. These procedures involve the removal of the prostate or a portion of the kidney, respectively.…”

“…In the urological field, in which the system has been primarily used, Hugo TM RAS was employed for radical and simple prostatectomies, radical cystectomies, radical and partial nephrectomies, and pyeloplasty procedures [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. In gynecology, the system can be used for hysterectomies, myomectomies, and sacrocolpopexies [ 13 , 14 ].…”