Initial Experience with the HUGO™ Robotic Surgery System in Gynecology

Overview

This study reports the first-year experience using the HUGO™ Robot-Assisted Surgery system for gynecological procedures at two tertiary referral centers. Thirty-two robotic surgeries were performed for benign and malignant indications, demonstrating feasibility, safety, and acceptable operative times with a learning curve evidenced by reduced docking times.

Background

Robotic surgery has become an established option in gynecology due to enhanced 3D visualization, precision, and instrument maneuverability. The Intuitive Da Vinci® system dominated the field until recent patent expirations allowed new platforms like the HUGO™ RAS system to emerge, aiming to reduce costs and increase accessibility. The HUGO™ system received CE mark approval in 2021 and has been adopted in select centers for various surgical specialties, but data on its use in gynecology remain limited. This study aims to provide initial insights into the system's application for benign and malignant gynecological surgeries.

Data Highlights

Key Findings

• The HUGO™ RAS system was successfully used in 32 gynecological surgeries over one year at two tertiary centers.
• Median docking time improved from 11 to 8 minutes, indicating a learning curve.
• Median console time varied by procedure: 49 min for radical hysterectomy, 41 min for adnexal surgery, and 121 min for pelvic floor surgeries.
• Median skin-to-skin operative times were 96.5 min for radical hysterectomy, 129 min for adnexal surgery, and 258 min for pelvic floor procedures.
• Majority of patients had benign indications; only 6.2% were treated for endometrial cancer.
• Patient baseline characteristics included median age 51.5 years, median BMI 24.3 kg/m2, and 43.8% with prior abdominal surgery.

Clinical Implications

The HUGO™ RAS system demonstrates feasibility and safety for a range of gynecological surgeries, including complex pelvic floor procedures. The observed reduction in docking time suggests that surgical teams can rapidly adapt to the new platform. This system may offer a cost-effective alternative to existing robotic platforms, potentially increasing access to robotic surgery in gynecology.

Conclusion

Early experience with the HUGO™ robotic system in gynecological surgery shows promising operative efficiency and safety profiles. Continued use and larger studies will further define its role and benefits in clinical practice.

References

1. Medtronic -- HUGO™ Robot-Assisted Surgery System CE Mark Approval 2021
2. San Paolo Hospital & Onze-Lieve-Vrouwziekenhuis -- Initial Clinical Experience 2022-2023