Initial experience of robot-assisted partial nephrectomy with Hugo™ RAS system: implications for surgical setting

Purpose Hugo™ RAS system is one of the most promising new robotic platforms introduced in the field of urology. To date, no data have been provided on robot-assisted partial nephrectomy (RAPN) performed with Hugo™ RAS system. The aim of the study is to describe the setting and report the performance of the first series of RAPN performed with Hugo™ RAS system. Methods Ten consecutive patients who underwent RAPN at our Institution between February and December 2022 were prospectively enrolled. All RAPN were performed transperitoneally with a modular four-arm configuration. The main outcome was to describe the operative room setting, trocar placement and the performance of this novel robotic platform. Pre, intra and post-operative, variables were recorded. A descriptive analysis was performed. Results Seven patients underwent RAPN for right-side and three for left-side masses. Median tumor size and PADUA score were 3 (2.2–3.7) cm and 9 (8–9), respectively. Median docking and console time were 9.5 (9–14) and 138 (124–162) minutes, respectively. Median warm ischemia time was 13 (10–14) minutes, and one case was performed clamp-less. Median estimated blood loss was 90 (75–100) mL. One major complication (Clavien-Dindo 3a) occurred. No case of positive surgical margin was recorded. Conclusion This is the first series to prove the feasibility of Hugo™ RAS system in the setting of RAPN. These preliminary results may help new adopters of this surgical platform to identify critical steps of robotic surgery with this platform and explore solutions before in-vivo surgery.