Robotic Surgery in Urology: History from PROBOT® to HUGOTM

Abstract

The advent of robotic surgical systems had a significant impact on every surgical area, especially urology, gynecology, and general and cardiac surgery. The aim of this article is to delineate robotic surgery, particularly focusing on its historical background, its evolution, its present status, and its future perspectives. A comprehensive literature review was conducted upon PubMed/MEDLINE, using the keywords “robotic surgical system”, “robotic surgical device”, “robotics AND urology”. Additionally, the retrieved articles’ reference lists were investigated. Analysis concentrated on urological surgical systems for laparoscopic surgery that have been given regulatory approval for use on humans. From the late 1980s, before daVinci® Era in 2000s, ancestor platform as Probot® and PUMA 560 were described to outline historical perspective. Thus, new robotic competitors of Intuitive Surgical such as Senhance®, Revo-I®, Versius®, Avatera®, Hinotori®, and HugoTM RAS were illustrated. Although daVinci® had high level competitiveness, and for many years represented the most plausible option for robotic procedures, several modern platforms are emerging in the surgical market. Growing competition through unique features of the new robotic technologies might extend applications fields, improve diffusion, and increase cost-effectiveness procedures. More experiences are needed to identify the role of these new advancements in surgical branches and in healthcare systems.

Surgical Outcomes of Hugo™ RAS Robot-Assisted Partial Nephrectomy for Cystic Renal Masses: Technique and Initial Experience

“…The median hemoglobin, creatinine, and eGFR at 1 month follow-up were 12 (10-14), 0.93 (0.86-0.97), and 79.9 (66.2-86.9), respectively. The median hemoglobin, creatinine, and eGFR at the last follow-up were 13 (11)(12)(13)(14), 0.86 (0.83-1.03), and 80.1 (70.4-86.9), respectively. The CT scans at 3 months showed no signs of persistence or recurrence of disease.…”

“…One such system is the Hugo™ RAS (Medtronic, Minneapolis, MN, USA©), designed as a multiport robotic system featuring four independent arm-carts, an “open” console, three-dimensional (3D) high-definition glasses with a head-tracking safety system, and gun-like ergonomic controllers. The key technical advantages include a more extensive working space for the bedside assistant, improved trocar positioning for better ergonomics, and overall cost-effectiveness [ 10 , 11 ].…”

Jornada médica: desafios e triunfos na prática da medicina 4

“…(Schuler PJ., et al, 2018) À medida que a experiência clínica avança e a tecnologia evolui, o papel destes novos sistemas em diferentes campos cirúrgicos e sistemas de saúde tornar-se-á mais claro. (Brassetti, Aldo et al, 2023) No ponto atual com a cirurgia robótica sendo cada vez mais utilizada no Brasil e no mundo, o que há alguns anos era projetado como futuro, podemos perceber que já está sendo uma realidade. Novos estudos são necessários para cada vez mais estabelecer a cirurgia robótica como padrão ouro no que se diz respeito ao cuidado minimamente invasivo em procedimentos urológicos.…”

Robot-assisted partial nephrectomy using the novel Hugo™ RAS system: Feasibility, setting and perioperative outcomes of the first off-clamp series

“…This system revolutionized surgical precision and possibility landscapes in a manner unparalleled by other previous techniques. 2 On the other hand, conventional laparoscopic surgery, which had already proven the advantages of minimally invasive techniques over the usual open approach, [3][4][5][6][7] suffered from an essential flaw: the lack of articulating instruments. This drawback rendered numerous surgical maneuvers exceedingly challenging, preventing surgeons from shifting all standard surgical procedures from the open approach to more minimally invasive technique.…”