A systematic review of global experiences with Medtronic's Hugo™ robotic system for robot-assisted partial nephrectomy.

Robotic-assisted partial nephrectomy (RAPN) has become a widely used modality for the excision of renal tumours. Medtronic's Hugo™ Robotic-Assisted Surgery (RAS) system has emerged as a promising alternative to the established Intuitive da Vinci® platform. Due to increasing use, this systematic review has been conducted to assess the safety and efficacy of the Hugo™ RAS system for RAPN. A comprehensive search was conducted to identify eligible studies that reported outcomes and experience of using the Hugo™ system for RAPN. Following appropriate screening and risk of bias assessment using ROBINS-I, results were collated into a narrative synthesis. Eight studies were included in the review. Within these, 145 patients had undergone RAPN using the Hugo™ system. These studies comprised one comparative and seven single-arm case series. Patient demographics, peri-operative outcomes, pathological outcomes and safety and feasibility parameters were extracted from the included studies. Across all these metrics, the Hugo™ system performed well. One notable finding was longer docking times compared to the da Vinci® system; however, with increasing experience and familiarity with this novel platform, this is expected to decrease. Despite the lack of high-quality evidence and few studies, the Hugo™ RAS system is a feasible option for conducting RAPN. It offered comparable and promising initial outcomes in several aspects compared to da Vinci®, alongside flexibility in docking setup. Further large-scale comparative studies are needed to corroborate the findings of this review and evaluate the longer term safety and efficacy of the Hugo™ RAS system for RAPN.