Implementation of Robot-assisted Urologic Surgeries Using Hugo RAS System in a High-volume Robotic "Da Vinci Xi"...

Area of Science:

• Robotic-assisted surgery
• Urological surgery
• Surgical innovation

Background:

• The Hugo Robotic-Assisted Surgery (RAS) system represents a new platform for minimally invasive procedures.
• Evaluating the initial experience with novel robotic systems is crucial for understanding their clinical application and challenges.

Purpose of the Study:

• To assess the safety, feasibility, and initial outcomes of the Hugo RAS platform in urological surgery.
• To describe trocar disposition, docking angles, surgical times, and functional results in the first 30 cases.

Main Methods:

• Retrospective, observational study of 30 consecutive urological surgeries using the Hugo RAS system.
• Evaluation of console and docking times, perioperative complications (Clavien-Dindo), blood loss, and arm collisions.
• Assessment of urinary continence and sexual function for radical prostatectomies.

Main Results:

• Procedures included radical prostatectomy (RARP), simple prostatectomy (RASP), partial nephrectomy (RAPN), and cystectomy (RARC).
• Median console operative times ranged from 78-82 minutes; median docking times were 10-12 minutes.
• No major complications or significant blood loss (<200 mL) were reported; 94.5% of RARP patients regained sexual function.

Conclusions:

• Implementation of the Hugo RAS system in a urological program is safe and feasible for high-volume surgeons with a trained team.
• Adaptations in patient positioning, trocar placement, and bed assistant ergonomics are necessary.
• Docking position and bed assistant ergonomics present the primary challenges during system implementation.