Robot-assisted partial nephrectomy using the Hugo™ RAS System: first multicentre study and Tetrafecta achievement

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robot-assisted partial nephrectomy (RAPN) is a standard procedure for kidney tumors.
• Evaluating new robotic platforms is crucial for advancing surgical techniques.
• The Hugo™ RAS system offers a novel approach to complex urological procedures.

Purpose of the Study:

• To assess perioperative outcomes of RAPN using the Hugo™ RAS system.
• To determine the rate of Tetrafecta achievement as a measure of surgical quality.
• To identify predictors of successful Tetrafecta achievement in Hugo™ RAS RAPN cases.

Main Methods:

• Multi-center data collection from five tertiary care centers performing RAPN with the Hugo™ RAS system.
• Definition of Tetrafecta: negative margins, no major complications (Clavien-Dindo Grade ≥II), and ≤30% GFR decline at 90 days.
• Analysis of 140 RAPN cases, including operative times, blood loss, complications, and Tetrafecta achievement.

Main Results:

• Successful RAPN with the Hugo™ RAS system in 140 patients; no conversions to open surgery.
• Tetrafecta rate achieved in 80% of cases.
• R.E.N.A.L. nephrometry score and surgeon experience were independent predictors of Tetrafecta achievement (P<0.05).

Conclusions:

• The Hugo™ RAS system facilitates safe and effective RAPN.
• A high Tetrafecta rate (80%) indicates satisfactory surgical quality.
• Findings support the adoption of the Hugo™ RAS system for RAPN procedures.