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Da Vinci vs. Hugo RAS for robot-assisted radical prostatectomy: a prospective comparative single-center study

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Abstract

Purpose

To evaluate Hugo RAS against the Da Vinci system for Robot-Assisted Radical Prostatectomy (RARP) in prostate cancer treatment.

Methods

We compared outcomes of 150 patients with prostate cancer undergoing RARP with either Hugo or Da Vinci systems. Our analysis included operative, postoperative, pathological, and functional outcomes.

Results

Both groups had 75 patients. Baseline characteristics and tumor features were similar. Intraoperatively, Da Vinci had a shorter docking time (10.45 vs. 18.62 min, p = 0.02), but total operative times were comparable (145.34 vs 138.95, p = 0.85). Hugo outperformed in neck dissection and lymphadenectomy times (22 vs 13.67 min, p = 0.027 and 37.82 vs 45.77 min, p = 0.025). Postoperative metrics like stay duration, catheter time, and complications showed no significant difference. Functional results, using IPSS and IIEF5, were similar between systems. Six Da Vinci patients (8%) and nine Hugo patients (12%) experienced social incontinence (p = 0.072). Pathological outcomes like T stage, Gleason Score, and nodes removed were alike. However, Hugo had more positive surgical margins (20% vs. 10.67%, p = 0.034).

Conclusions

RARP outcomes using Hugo RAS were similar to the Da Vinci system in our study. More research and extended follow-up are required to ascertain long-term oncological and functional results.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

References

  1. Mazzone E, Mistretta FA, Knipper S et al (2019) Contemporary national assessment of robot-assisted surgery rates and total hospital charges for major surgical uro-oncological procedures in the united states. J Endourol 33(6):438–447. https://doi.org/10.1089/end.2018.0840

    Article  PubMed  Google Scholar 

  2. Binder J, Jones J, Bentas W et al (2002) Robot-assisted laparoscopy in urology radical prostatectomy and reconstructive retroperitoneal interventions. Urol Ausg A. 41(2):144–149. https://doi.org/10.1007/s00120-002-0178-2

    Article  CAS  Google Scholar 

  3. Hegarty NJ, Kaouk JH (2006) Radical prostatectomy: a comparison of open, laparoscopic and robot-assisted laparoscopic techniques. Can J Urol 13(Suppl 1):56–61

    PubMed  Google Scholar 

  4. Ilic D, Evans SM, Allan CA, Jung JH, Murphy D, Frydenberg M (2017) Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD009625.pub2

    Article  PubMed  PubMed Central  Google Scholar 

  5. Yaxley JW, Coughlin GD, Chambers SK et al (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet Lond Engl 388(10049):1057–1066. https://doi.org/10.1016/S0140-6736(16)30592-X

    Article  Google Scholar 

  6. EAU Guidelines on Prostate Cancer - Uroweb. Uroweb—European Association of Urology. https://uroweb.org/guidelines/prostate-cancer. Accessed 5 Sep 2023

  7. Pal RP, Koupparis AJ (2018) Expanding the indications of robotic surgery in urology: a systematic review of the literature. Arab J Urol 16(3):270–284. https://doi.org/10.1016/j.aju.2018.05.005

    Article  PubMed  PubMed Central  Google Scholar 

  8. Salkini MW (2020) The role of robot-assisted radical prostatectomy in high-risk organ-confined prostate cancer. Urol Ann 12(1):1–3. https://doi.org/10.4103/UA.UA_135_19

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sarchi L, Mottaran A, Bravi CA et al (2022) Robot-assisted radical prostatectomy feasibility and setting with the Hugo™ robot-assisted surgery system. BJU Int 130(5):671–675. https://doi.org/10.1111/bju.15819

    Article  PubMed  Google Scholar 

  10. Ragavan N, Bharathkumar S, Chirravur P, Sankaran S, Mottrie A (2022) Evaluation of Hugo RAS system in major urologic surgery: our initial experience. J Endourol 36(8):1029–1035. https://doi.org/10.1089/end.2022.0015

    Article  PubMed  Google Scholar 

  11. Rocco B, Sighinolfi MC, Sarchi L et al (2023) First case of robot-assisted radical cystectomy and intracorporeal neobladder reconstruction with the Hugo RAS system: step-by-step surgical setup and technique. J Robot Surg. https://doi.org/10.1007/s11701-023-01629-4

    Article  PubMed  Google Scholar 

  12. Gallioli A, Uleri A, Gaya JM et al (2023) Initial experience of robot-assisted partial nephrectomy with Hugo™ RAS system: implications for surgical setting. World J Urol 41(4):1085–1091. https://doi.org/10.1007/s00345-023-04336-9

    Article  PubMed  Google Scholar 

  13. Bravi CA, Paciotti M, Balestrazzi E et al (2023) Outcomes of robot-assisted radical prostatectomy with the Hugo RAS surgical system: initial experience at a high-volume robotic center. Eur Urol Focus S2405–4569(23):00025–00031. https://doi.org/10.1016/j.euf.2023.01.008

    Article  Google Scholar 

  14. Elorrieta V, Villena J, Kompatzki Á, Velasco A, Salvadó JA (2023) ROBOT assisted laparoscopic surgeries for nononcological urologic disease: initial experience with Hugo Ras system. Urology 174:118–125. https://doi.org/10.1016/j.urology.2023.01.042

    Article  PubMed  Google Scholar 

  15. Mottaran A, Paciotti M, Bravi CA et al (2023) Robot-assisted simple prostatectomy with the novel HUGO™ RAS System: feasibility, setting, and perioperative outcomes. Minerva Urol Nephrol 75(2):235–239. https://doi.org/10.23736/S2724-6051.22.05031-5

    Article  PubMed  Google Scholar 

  16. Panico G, Vacca L, Campagna G et al (2023) The first 60 cases of robotic sacrocolpopexy with the novel HUGO RAS system: feasibility, setting and perioperative outcomes. Front Surg 10:1181824. https://doi.org/10.3389/fsurg.2023.1181824

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hughes T, Rai B, Madaan S, Chedgy E, Somani B (2023) The availability, cost, limitations, learning curve and future of robotic systems in urology and prostate cancer surgery. J Clin Med 12(6):2268. https://doi.org/10.3390/jcm12062268

    Article  PubMed  PubMed Central  Google Scholar 

  18. HugoTM RAS System. https://www.medtronic.com/covidien/en-gb/robotic-assisted-surgery/hugo-ras-system.html. Accessed 10 Sep 2023

  19. Bravi CA, Balestrazzi E, De Loof M et al (2023) Robot-assisted radical prostatectomy performed with different robotic platforms: first comparative evidence between da vinci and HUGO robot-assisted surgery robots. Eur Urol Focus. https://doi.org/10.1016/j.euf.2023.08.001

    Article  PubMed  Google Scholar 

  20. Ragavan N, Bharathkumar S, Chirravur P, Sankaran S (2023) Robot-assisted laparoscopic radical prostatectomy utilizing Hugo RAS platform: initial experience. J Endourol 37(2):147–150. https://doi.org/10.1089/end.2022.0461

    Article  PubMed  Google Scholar 

  21. WMA—The World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/. Accessed 13 June 2023

  22. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae

    Article  PubMed  PubMed Central  Google Scholar 

  23. Martini A, Falagario UG, Villers A et al (2020) Contemporary techniques of prostate dissection for robot-assisted prostatectomy. Eur Urol 78(4):583–591. https://doi.org/10.1016/j.eururo.2020.07.017

    Article  PubMed  Google Scholar 

  24. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV (2003) Technique for laparoscopic running urethrovesical anastomosis:the single knot method. Urology 61(4):699–702. https://doi.org/10.1016/s0090-4295(02)02543-8

    Article  PubMed  Google Scholar 

  25. Mattei A, Fuechsel FG, Bhatta Dhar N et al (2008) The template of the primary lymphatic landing sites of the prostate should be revisited: results of a multimodality mapping study. Eur Urol 53(1):118–125. https://doi.org/10.1016/j.eururo.2007.07.035

    Article  PubMed  Google Scholar 

  26. Fossati N, Willemse PPM, Van den Broeck T et al (2017) The benefits and harms of different extents of lymph node dissection during radical prostatectomy for prostate cancer: a systematic review. Eur Urol 72(1):84–109. https://doi.org/10.1016/j.eururo.2016.12.003

    Article  PubMed  Google Scholar 

  27. Totaro A, Campetella M, Bientinesi R et al (2022) The new surgical robotic platform HUGOTM RAS: System description and docking settings for robot-assisted radical prostatectomy. Urologia 89(4):603–609. https://doi.org/10.1177/03915603221107855

    Article  PubMed  Google Scholar 

  28. Bravi CA, Paciotti M, Sarchi L et al (2022) Robot-assisted radical prostatectomy with the novel Hugo robotic system: initial experience and optimal surgical set-up at a tertiary referral robotic center. Eur Urol 82(2):233–237. https://doi.org/10.1016/j.eururo.2022.04.029

    Article  PubMed  Google Scholar 

  29. Marques-Monteiro M, Teixeira B, Mendes G et al (2023) Extraperitoneal robot-assisted radical prostatectomy with the HugoTM RAS system: initial experience of a tertiary center with a high background in extraperitoneal laparoscopy surgery. World J Urol. https://doi.org/10.1007/s00345-023-04571-0

    Article  PubMed  Google Scholar 

  30. Alfano CG, Moschovas MC, Montagne V et al (2023) Implementation and outcomes of Hugo(TM) RAS System in robotic-assisted radical prostatectomy. Int Braz J Urol Off J Braz Soc Urol 49(2):211–220. https://doi.org/10.1590/S1677-5538.IBJU.2023.9902

    Article  Google Scholar 

  31. Paciotti M, Bravi CA, Mottaran A et al (2023) Nerve-sparing robot-assisted radical prostatectomy with the HUGO™ robot-assisted surgery system using the ‘Aalst technique.’ BJU Int 132(2):227–230. https://doi.org/10.1111/bju.16084

    Article  PubMed  Google Scholar 

  32. Carbonara U, Srinath M, Crocerossa F et al (2021) Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes. World J Urol 39(10):3721–3732. https://doi.org/10.1007/s00345-021-03687-5

    Article  PubMed  Google Scholar 

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Funding

The authors have not received any financial support or grants for the research presented in this article.

Author information

Authors and Affiliations

  1. Department of Urology, Hospital Universitario HM Sanchinarro, HM Hospitales and ROC Clinic, Madrid, Spain

    Ricardo Brime Menendez, Esther García Rojo, Vital Hevia Palacios, Javier Amalio Feltes Ochoa, Juan Justo Quintas, Fernando Lista Mateos, Agustín Fraile & Javier Romero Otero

  2. Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Celeste Manfredi

  3. Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

    Simone Belli

  4. Department of Urology, Sant’Anna Hospital, San Fermo della Battaglia, Como, Italy

    Giorgio Bozzini

Authors
  1. Ricardo Brime Menendez
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  2. Esther García Rojo
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  3. Vital Hevia Palacios
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  4. Javier Amalio Feltes Ochoa
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  11. Javier Romero Otero
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Contributions

Ricardo Brime Menendez1, Esther García Rojo1, Vital Hevia Palacios1, Javier Amalio Feltes Ochoa1, Juan Justo Quintas1, Fernando Lista Mateos1, Agustín Fraile1, Celeste Manfredi2, Simone Belli3, Giorgio Bozzini4, Javier Romero Otero1* Authors whose names appear on the submission have contributed sufficiently to the scientific work and, therefore, share collective responsibility and accountability for the results. R. Brime Protocol development, Data collection, Manuscript editing and writing. E. García. Protocol development, Data collection, Manuscript editing and writing. V. Hevia Protocol development, Data collection, Manuscript editing and writing. J.A. Feltes Protocol development, Data collection. J. Justo Protocol development, Data collection. F. Lista Protocol development, Data collection. A. Fraile Protocol development, Data collection. C. Mafredi Protocol development, Manuscript editing and writing. S. Bellli Manuscript editing and writing. G. Bozzini Protocol development, Data collection, Manuscript editing and writing. J Romero: protocol development, Data collection, Manuscript editing and writing.

Corresponding author

Correspondence to Javier Romero Otero.

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VHP, JRO, and RBM have affiliations as proctors of Medtronic.

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Brime Menendez, R., García Rojo, E., Hevia Palacios, V. et al. Da Vinci vs. Hugo RAS for robot-assisted radical prostatectomy: a prospective comparative single-center study. World J Urol 42, 336 (2024). https://doi.org/10.1007/s00345-024-05045-7

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