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Early Experience of Hinotori Robot System in General Surgery: A Systematic Review
Clara Avelar Mendes de Vasconcellos1, Gabriela Lyons2, Matheus Daniel Faleiro3
1Estácio de Sá University/IDOMED, Rio de Janeiro, Brazil.
Purpose:
Robotic-assisted surgery has enhanced visualization, precision, and dexterity in general surgery. While the da Vinci system predominates, newer platforms such as the Hinotori Surgical Robot System (Hinotori) have emerged. This systematic review evaluates early clinical experience with Hinotori in general surgery, focusing on procedural characteristics and perioperative outcomes.
Materials And Methods:
A systematic review was conducted according to PRISMA guidelines. MEDLINE/PubMed, EMBASE, Cochrane Library, and Web of Science were searched through March 2026 using the terms "Hinotori Surgical Robot System," "General Surgery," and "Minimally Invasive Surgery." Risk of bias was assessed using ROBINS-I. Studies reporting general surgical procedures with postoperative outcomes were included; conference abstracts were excluded. Data extracted included study design, procedure type, console time, operative time, blood loss, complications, and length of stay (LOS).
Results:
Of 475 records screened, 15 studies met inclusion criteria (4 case reports and 11 retrospective cohorts), all conducted in Japan (2023 to 2026), comprising 296 patients. Colorectal surgeries predominated (57.1%), followed by gastric procedures (25%). Console times ranged from 252 to 400 min (gastric), 213 to 325 min (colorectal), 252 min (esophageal), 239 to 350 min (pancreatic), and 292 min (biliary). No intraoperative complications or conversions were reported. Median blood loss ranged from 3 to 164 mL. LOS varied by procedure type (8-41 days). Postoperative complications were infrequent and primarily Clavien-Dindo Grades I-II. Comparative studies with the da Vinci system have demonstrated similar perioperative outcomes, with the main differences related to platform use, particularly longer operative and console times.
Conclusions:
Early evidence supports the feasibility and safety of the Hinotori system across multiple general surgical procedures, with outcomes comparable to the da Vinci platform. Larger comparative studies with longer follow-up and cost-effectiveness analyses are needed to define its clinical role.
Study Registration:
A review protocol for this systematic review was registered in PROSPERO (CRD420250637267).
