Intraoperative outcomes of robotic surgery across multiple multimodal systems

Area of Science:

• Anesthesiology
• Robotic Surgery
• Surgical Innovation

Background:

• New multi-modular robotic surgical systems (Hugo RAS, Versius) present architectural and ergonomic differences from the Da Vinci platform.
• Surgical performance of new systems is studied, but anesthesiological outcomes require further investigation.
• Limited data exist on comparative anesthesiological outcomes across different robotic surgical platforms.

Purpose of the Study:

• To compare intraoperative anesthetic parameters across three robotic surgical platforms: Da Vinci, Hugo RAS, and Versius.
• To evaluate the anesthesiological safety and intraoperative performance of novel robotic systems.
• To provide data supporting the integration of new robotic platforms into clinical practice.

Main Methods:

• Retrospective observational analysis of 258 patients undergoing robotic surgery (abdominal, urological, gynecological).
• Patients stratified by robotic platform: Da Vinci, Hugo RAS, or Versius.
• Comparison of intraoperative variables: Trendelenburg angle, anesthesia duration, pneumoperitoneum time, urine output, and fluid balance.

Main Results:

• Da Vinci system used in 68.6% of cases, Versius (15.9%), Hugo RAS (15.5%).
• No major differences in anesthesiological or postoperative outcomes observed across platforms.
• Higher intraoperative urine output with Versius (gynecological surgery); steeper Trendelenburg with Da Vinci (colorectal); shorter operative/pneumoperitoneum times with Versius (abdominal wall).

Conclusions:

• Hugo RAS and Versius demonstrate comparable anesthesiological safety to the Da Vinci platform.
• Intraoperative performance of Hugo RAS and Versius is comparable to the Da Vinci platform.
• These findings support the safe clinical integration of Hugo RAS and Versius robotic surgical systems.