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. 2024 Oct 3;13(19):5916.
doi: 10.3390/jcm13195916.

Extraperitoneal Robot-Assisted Radical Prostatectomy with the Hugo™ RAS System: Initial Experience at a High-Volume Robotic Centre

Marcello Scarcia  1 , Giovanni Battista Filomena  1   2 , Stefano Moretto  1   3   4 , Filippo Marino  1   2 , Simone Cotrufo  1 , Alessandra Francocci  1   2 , Francesco Paolo Maselli  1 , Giuseppe Cardo  1 , Giovanni Pagliarulo  1 , Pierluigi Rizzo  1 , Pierluigi Russo  2 , Michele Di Dio  5 , Stefano Alba  6 , Roberto Calbi  7 , Michele Romano  1 , Michele Zazzara  1 , Giuseppe Mario Ludovico  1
Affiliations

Extraperitoneal Robot-Assisted Radical Prostatectomy with the Hugo™ RAS System: Initial Experience at a High-Volume Robotic Centre

Marcello Scarcia et al. J Clin Med. .

Abstract

Background: The Hugo™ Robotic-Assisted Surgery (Hugo™ RAS) system represents a novel advancement in robotic surgical technology. Despite this, there remains a scarcity of data regarding extraperitoneal robot-assisted radical prostatectomy (eRARP) using this system. Methods: We conducted a prospective study at Ospedale Regionale "F. Miulli" from June 2023 to January 2024, enrolling consecutive patients diagnosed with prostate cancer (PCa) undergoing eRARP ± lymph node dissection. All procedures employed a modular four-arm setup performed by two young surgeons with limited prior robotic surgery experience. This study aims to evaluate the safety and feasibility of eRARP using the Hugo™ RAS system, reporting comprehensive preoperative, intraoperative, and postoperative outcomes in the largest reported cohort to date. Results: A total of 50 cases were analyzed, with a mean patient age of 65.76 (±5.57) years. The median operative time was 275 min (Q1-Q3 150-345), and the console time was 240 min (Q1-Q3 150-300). The docking time averaged 10 min (Q1-Q3 6-20). There were no intraoperative complications recorded. Two major complications occurred within the first 90 days. At the 3-month mark, 36 patients (72%) achieved undetectable PSA levels (<0.1 ng/mL). Social continence was achieved by 66% of patients, while 40% maintained erectile function. Conclusions: eRARP utilizing the Hugo™ RAS system demonstrated effectiveness and safety in our study cohort. However, more extensive studies with larger cohorts and longer follow-up periods are necessary to thoroughly evaluate long-term outcomes.

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

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Trocar placement in extraperitoneal RARP (eRARP).
Figure 2
Figure 2
HUGO™ RAS system operative room settings, tilt and docking angles (DAs).
See this image and copyright information in PMC

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