Hugo™ RAS for robot-assisted radical prostatectomy: outcomes from a consecutive single-center study at a Hugo-exclusive institution

Most early reports on the Hugo™ Robotic- assisted surgery (RAS) system originated from institutions with concurrent access to established robotic platforms, potentially introducing device selection bias. We conducted a retrospective assessment of 103 patients with localized prostate cancer treated using Hugo™ RAS-assisted robot-assisted radical prostatectomy at a Japanese municipal hospital where no alternative robotic platform was available. The analysis focused on perioperative performance, safety outcomes, and consistency of procedural implementation. A standardized surgical setup, including a W-shaped port configuration and predefined floor-marking-based docking strategy, was applied. Surgery was carried out by six surgeons with different levels of robotic experience, including one surgeon without prior robotic operative experience. Operative, console, and docking durations showed median values of 152 min (IQR 129–218.5), 108 min (IQR 85–174.5), and 5 min (IQR 4–7), respectively. Estimated intraoperative blood loss was 100 mL (IQR 50–214). Neither intraoperative blood transfusion nor conversion to open surgery was necessary in any patient. Postoperative complications occurred in four patients (3.9%), including one major complication (Clavien–Dindo > II; 1.0%). Positive surgical margins were observed in 35 patients (34.0%) and 79.6% achieved urinary continence at 3 months. In this Hugo-exclusive, single-platform environment, RARP using the Hugo™ RAS system was performed without major safety concerns across surgeons with varying experience. Although four independent-arm carts needed to be rolled in, the median docking time was 5 min, possibly facilitated by a standardized floor-marking strategy adopted at our institution.