A systematic scoping review of Hugo™ RAS (robot-assisted surgery) docking concordance in gynecologic robotic surgery

The Hugo™ RAS system (Medtronic) is a modular four-arm robotic platform increasingly used in gynecologic surgery since its 2021 European approval. A first international Delphi exercise on docking was published in 2026, but whether published practice aligns with it, and how completely docking variables are reported, remains unmapped. We conducted a systematic scoping review (PRISMA Extension for Scoping Reviews, PRISMA-ScR) with structured analytical extensions of the gynecologic Hugo™ RAS literature published 1 January 2022-15 May 2026, searching PubMed, Embase, Scopus, Cochrane CENTRAL, ClinicalTrials.gov, WHO ICTRP, and grey literature. Two reviewers independently extracted seven in-depth sources; agreement used Cohen's weighted κ, with every disagreement reconciled against the source. Each recommendation was scored concordant, discordant, or not assessable against the conventional two-thirds (66.7%) Delphi threshold. Effect estimates were not pooled; the extensions are descriptive mapping tools, not a meta-analysis. Inter-rater agreement on coding was almost perfect for the proposed Hugo Docking Minimum Reporting Set (HuDoc-MRS; κ 0.927) and substantial for concordance (κ 0.808). Of recommendations crossing the 66.7% threshold, only the modified-bridge configuration (15/16, 93.7% panel) also exceeded 50% uptake across the six clinical cohorts and is therefore the only recommendation both consensus-supported and consistently reported. Two anthropometry-driven modifications (increased inter-port distance for body mass index > 30; cranial port displacement for an enlarged uterus; each 11/16, 68.7% panel) showed low uptake (≤ 22% and ≤ 8%), the principal translation gap. No included study formally codified external arm collisions; reporting was verbal only. In the gynecologic Hugo™ RAS literature to date, the modified-bridge configuration is the only recommendation both strongly endorsed by the 2026 Delphi panel and consistently applied across the included cohorts. Anthropometry-driven modifications are consensus-supported but rarely reported-an actionable translation gap, not evidence of disuse. External collisions remain uncodified; the HuDoc-MRS is proposed as a candidate minimum reporting set to improve future comparability.