Robotic-assisted partial nephrectomy using the HugoTM robotic-assisted surgery platform Initial experience and insights

Abstract

INTRODUCTION: Robotic-assisted surgery (RAS) is a vital modality in the armamentarium of minimally invasive surgeons. The Hugo™ RAS system (Medtronic®) is one of the newest platforms on the market and has little surgical outcomes data. Herein, we describe our early experience performing robotic-assisted partial nephrectomy (RAPNx) with the Hugo™ RAS platform. METHODS: We conducted a retrospective review of patients who underwent a RAPNx with the Hugo™ RAS platform between April and December 2023 at the University Health Network in Toronto, ON. One surgeon performed all procedures using a three-arm transperitoneal approach. Anesthetic, operative, and pathologic reports were assessed to collect pre-, intra- and postoperative variables. RESULTS: Eleven patients were included. The mean age was 51 years, 45.0% were female, and 63.6% had a right-sided mass. Mean tumor size was 2.9 cm. Mean warm ischemia time was 18.9 minutes (standard deviation [SD] 7.12) and mean estimated blood loss was 179 ml (SD 63.6). Mean robot docking time was 232 seconds (SD 106.5), mean total console time was 93 minutes (SD 21.4), and mean total operative time was 165.6 minutes (SD 34.1). There were no intraoperative complications. On pathology review, most tumors were a clear-cell variant (72.7%) and staged pT1a (81.8%). All margins were negative. One patient sustained a port site infection. CONCLUSIONS: This is the first North American case series using the Hugo™ RAS platform for RAPNx. Our findings underscore that the platform is safe and effective for performing RAPNx with comparable outcomes to other robotic platforms.