Robotic Hepatectomy Using the Hugo RAS System: Initial Experience and Technical Considerations

Robotic hepatectomy using the Hugo robotic-assisted surgery (RAS) system has recently been introduced; however, clinical experience remains limited. We report our initial experience in five patients, focusing on surgical techniques and short-term outcomes. All procedures were completed robotically without conversion to open or laparoscopic surgery. The median operative time was 175 min (range, 162-209), and the median console time was 100 min (range, 79-139). The median inflow occlusion time was 31 min (range, 14-62). Intraoperative blood loss was minimal, with a median of 0 mL (range, 0-10). No intraoperative or postoperative complications were observed. The median postoperative hospital stay was 7 days (range, 4-11). The series included lesions in both left- and right-sided liver segments, including technically demanding areas such as segment 7. These findings suggest that Hugo RAS minor hepatectomy appears feasible and safe in selected cases, with favorable short-term outcomes.