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Review
. 2024 Apr 26;13(9):2551.
doi: 10.3390/jcm13092551.

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Filippo Marino  1   2   3 , Stefano Moretto  4   5 , Francesco Rossi  1   2   6 , Carlo Gandi  1   2 , Filippo Gavi  1   2 , Riccardo Bientinesi  1   2 , Marco Campetella  2   6 , Pierluigi Russo  1   2 , Francesco Pio Bizzarri  1   2   6 , Eros Scarciglia  1   2 , Mauro Ragonese  1   2 , Nazario Foschi  1   2 , Angelo Totaro  1   2 , Nicolò Lentini  7 , Roberta Pastorino  7   8 , Emilio Sacco  2   6
Affiliations
Review

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Filippo Marino et al. J Clin Med. .

Abstract

Background/Objectives: to assess surgical, oncological, and functional outcomes of robot-assisted radical prostatectomy (RARP) performed using the novel Hugo™ RAS system. Methods: A systematic review was conducted following the PRISMA guidelines, using PubMed, Web of Science, Scopus, and Embase databases. Eligible papers included studies involving adult males undergoing RARP with the Hugo™ RAS platform, with at least ten patients analyzed. The pooled analysis was performed using a random-effect model. Results: Quantitative analysis was conducted on 12 studies including 579 patients. The pooled median docking time, console time, and operative time were 11 min (95% CI 7.95-14.50; I2 = 98.4%, ten studies), 142 min (95% CI 119.74-164.68; I2 = 96.5%, seven studies), and 176 min (95% CI 148.33-203.76; I2 = 96.3%, seven studies), respectively. The pooled median estimated blood loss was 223 mL (95% CI 166.75-280.17; I2 = 96.5%, eleven studies). The pooled median length of hospital stay and time to catheter removal were 2.8 days (95% CI 1.67-3.89; I2 = 100%, ten studies) and 8.3 days (95% CI 5.53-11.09; I2 = 100%, eight studies), respectively. The pooled rate of postoperative CD ≥ 2 complications was 4.1% (95% CI 1-8.5; I2 = 63.6%, eleven studies). The pooled rate of positive surgical margins and undetectable postoperative PSA were 20% (95% CI 12.6-28.5; I2 = 71.5%, nine studies) and 94.2% (95% CI 87.7-98.6; I2 = 48.9%, three studies), respectively. At three months, a pooled rate of social continence of 81.9% (95% CI 73.8-88.9; I2 = 66.7%, seven studies) was found. Erectile function at six months was 31% in one study. Conclusions: despite the preliminary nature of the evidence, this systematic review and pooled analysis underscores the feasibility, safety, and reproducibility of the Hugo™ RAS system in the context of RARP.

Keywords: Hugo RAS system; outcomes; prostate cancer; robot-assisted radical prostatectomy; robotic surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for the selection process.
Figure 2
Figure 2
Risk of bias assessment [3,18,19,20,21,22,23,24,25,26,27,28].
Figure 3
Figure 3
Duration of surgery: (A) docking time with subgroup analysis based on risk of bias, (B) console time, and (C) operative time. CI, confidence interval [3,19,20,21,22,23,24,25,26,27,28].
Figure 4
Figure 4
Continuous variables: (A) number of nodes removed, (B) estimated blood loss with subgroup analysis based on risk of bias, (C) length of stay with subgroup analysis based on risk of bias, and (D) time to catheter removal. CI, confidence interval [3,19,20,21,22,23,24,25,26,27,28].
Figure 5
Figure 5
Dichotomous variables: (A) Clavien–Dindo complications ≥ 2 with subgroup analysis based on risk of bias, (B) positive surgical margins, (C) undetectable PSA level at first follow-up after surgery, and (D) social continence at 3 months. PSA, prostate specific antigen; CI, confidence interval [3,19,20,21,22,23,24,25,26,27,28].
See this image and copyright information in PMC

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