Medtronic’s Hugo ™ robotic surgery system for robot-assisted radical prostatectomy: a systematic review of current worldwide experiences

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2024

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Tehrani, M.S.
Shepherd, A.
Challacombe, B.

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Journal of Robotic Surgery, 2024; 18(1):352-1-352-14

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Mehrshad Sultani Tehrani, Andrew Shepherd, Ben Challacombe

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Abstract

Urology’s pioneering role in surgical innovations, from cystoscopy to laparoscopic surgery, culminated in the twenty-frstcentury advent of robotic surgery. The dominant da Vinci® system faced new competition following its 2019 patent expiration. Medtronic’s Hugo™ system emerged. Its growing global adoption, especially in robot-assisted radical prostatectomy (RARP), necessitates a systematic review, evaluating safety, feasibility, and comparison with established systems. A comprehensive search identifed eligible studies of the Hugo™ robotic platform for RARP, presenting their current experiences. Following systematic screening, quality of eligible studies was assessed using ROBINS-I. Results then underwent a narrative synthesis. This systematic review analysed 19 eligible studies, consisting of 9 comparative and 10 single arm studies. Due to the non-randomised nature of the studies, a moderate risk of bias was concluded in most. On account of the high heterogeneity between studies, a narrative synthesis of data was enacted; categorised into themes relating to operative timings, transfer of skills, patient demographics, plus safety and feasibility. Eligible studies demonstrated the promise of the Hugo™ platform within these themes, in comparison to currently available platforms. Despite a paucity of high-quality randomised controlled trials, available evidence indicates Hugo™ as a promising, safe alternative for RARP. Positive experiences across diverse centres and surgeons revealed minimal diferences in surgical outcomes compared to the established da Vinci® system, fostering global Hugo™ adoption. Despite evidence demonstrating Hugo™ safety and comparability, the review underscores the scarcity of high-quality evidence, attributing it to early stage implementation challenges.

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© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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