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

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.

Use of HugoTM RAS in General Surgery: The First 70 Cases at a German Centre and a Systematic Review of the Literature

“…Reports on the clinical use of Hugo first began appearing after the device had received its CE mark in the EU for use in gynaecologic and urologic surgery in October 2021 and for general surgery a year later. So far, about 60 Hugo™ RAS devices have been installed in Europe alone, showing promising results for prostatectomy, nephrectomy and hysterectomy [1][2][3]. It is believed that the open modular design of the platform would also allow its rapid adoption in general surgery.…”