Extraperitoneal robot-assisted radical prostatectomy with the Hugo™ RAS system: 100 consecutive cases, 1-year...

Area of Science:

• Urology
• Surgical Technology
• Robotics in Medicine

Background:

• The Hugo™ Robotic-Assisted Surgery (RAS) system is an emerging platform with limited evidence for extraperitoneal robot-assisted radical prostatectomy (eRARP).
• Assessing the initial performance and learning curve of the Hugo™ RAS system in eRARP is crucial for understanding its potential.

Purpose of the Study:

• To prospectively evaluate the feasibility, safety, and outcomes of eRARP using the Hugo™ RAS system.
• To analyze the learning-curve dynamics and temporal trends in operative performance and complications.

Main Methods:

• A prospective, single-center study included 100 patients undergoing eRARP with the Hugo™ RAS system.
• Data collected included preoperative, intraoperative, pathological, and postoperative outcomes up to 12 months.
• The cohort was divided into the first 50 and last 50 cases to assess learning-curve effects.

Main Results:

• No intraoperative conversions or complications occurred; major postoperative complications (Clavien-Dindo grade III+) were 2%.
• At 12 months, undetectable PSA was 80%, social continence 87%, and erectile function recovery 51%.
• The learning curve demonstrated reduced operative time (275 to 210 min), improved docking time, decreased clinically significant positive surgical margins (28% to 14%), and fewer complications (26% to 4%).

Conclusions:

• Extraperitoneal robot-assisted radical prostatectomy using the Hugo™ RAS system is feasible and safe.
• A significant learning-curve effect was observed, leading to improved efficiency and safety.
• Oncological and functional outcomes were preserved, but longer follow-up and multicenter studies are needed.