Comparing the perioperative outcomes of radical prostatectomy using the da Vinci Xi and the novel Hugo™ robotic assisted surgery system in a matched study

O bjective The novel Hugo™ Robot-Assisted Surgery (RAS) system (Medtronic, USA) has been introduced recently, and increasing evidence suggests its safety and feasibility. We report a matched study comparing the peri-operative outcome of Hugo™ robotic-assisted radical prostatectomy (RARP) and da Vinci Xi assisted RARP. Between January 2021 and August 2023, 20 patients and 91 patients with localized prostatic cancer underwent Hugo™, and da Vinci Xi assisted RARP, respectively. Data were prospectively collected for analysis. Two groups of 20 patients were genetically matched for comparative study. The baseline characteristics of both groups were matched. In both groups, pelvic lymphadenectomy was carried out in 8 (40 %) patients. No intra-operative complications were reported in either group. The median console time was shorter in the Hugo group™ (181 vs 222 min, CI 95 % −68.3 to −5.2, p = 0.023). No significant differences were observed regarding the mean operative blood loss and hospital stay. The duration of catheterization for the Hugo group was shorter than the Xi group (IRR 0.8, 95 % CI 0.68–0.94, p = 0.007). No significant difference in positive surgical margin rates, continence rates and potency recovery at 3 months was observed. All patients achieved undetectable PSA levels <0.03 ng/ml at 3 months. Hugo™ RAS assisted radical prostatectomy provides satisfactory initial outcomes comparable with those of the existing robotic platform. However, further studies are needed to explore the long-term outcomes of the HugoTM RAS system.