Journal of the European Society for Gynaecological Endoscopy


The new surgical robot Hugo™ RAS for total hysterectomy: a pilot study

G. Monterossi1, L. Pedone Anchora1, R. Oliva1,2, A. Fagotti1,2, F. Fanfani1,2, B. Costantini1, A. Naldini1, D. Giannarelli3, G. Scambia1,2

1 Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2 Università Cattolica del Sacro Cuore, Rome, Italy
3 Facility of Epidemiology and Biostatistics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy


Robotic surgery, hysterectomy, surgical outcomes, malfunction, safety, Hugo

Published online: Dec 13 2023


Background: With the rising popularity of robotic surgery, Hugo™ RAS is one of the newest surgical robotic platforms. Investigating the reliability of this tool is the first step toward validating its use in clinical practice; and presently there arelimited data available regarding this. The literature is constantly enriched with initial experiences, however no study has demonstrated the safety of this platform yet.

Objectives: This study aimed to investigate its reliability during total hysterectomy.

Materials and Methods: A series of 20 consecutive patients scheduled for minimally invasive total hysterectomy with or without salpingo-oophorectomy for benign disease or prophylactic surgery were selected to undergo surgery with Hugo™ RAS. Data regarding any malfunction or breakdown of the robotic system as well as intra- and post-operative complications were prospectively recorded.

Results: Fifteen of the twenty patients (75.0%) underwent surgery for benign uterine diseases, and five (25.0%) underwent prophylactic surgery. Among the entire series, an instrument fault occurred in one case (5.0%). The problem was solved in 4.8 minutes and without complications for the patient. The median total operative time was 127 min (range, 98–255 min). The median estimated blood loss was 50 mL (range:30–125 mL). No intraoperative complications were observed. One patient (5.0%) developed Clavien-Dindo grade 2 post-operative complication.

Conclusions: In this pilot study, Hugo™ RAS showed high reliability, similar to other robotic devices.

What is new? Present findings suggest that Hugo™ RAS is a viable option for major surgical procedures and deserves further investigation in clinical practice.