EPD107 - JSCP Traveling Fellowship: Multicenter retrospective observational study on the utility of the Hugo RAS system in robot-assisted colorectal surgery

Author
Masaaki Miyo1,2, Koichi Okuya2, Tsutomu Kumamoto3, Hiro Junichiro3, Koki Otsuka3, Yoshiro Itatani4, Koya Hida4, Ichiro Takemasa2,5
1: Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
2: Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan
3: Department of Surgery, Fujita Health University, Toyoake, Japan
4: Department of Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan
5: Department of Surgery, Osaka International Medical and Science Center, Osaka Keisatsu Hospital, Osaka, Japan
Introduction
In Japan, the da Vinci Surgical System (DVSS) received insurance coverage for rectal procedures in 2018 and has since been widely adopted. While DVSS has led the surgical robotics market, new systems have emerged globally. The Hugo RAS system, approved for gastroenterological surgery in July 2023, features independent arm carts and an open console, allowing flexible setup based on the surgical technique and patient's body shape and shared 3D imaging—offering a distinct concept from DVSS and expanding future possibilities in robotic surgery. This study evaluated short-term outcomes of initial colorectal procedures using the Hugo RAS system in Japan.
Methods
We evaluated the postoperative outcomes of 118 patients who underwent colorectal surgery using the Hugo™ RAS system at three institutions—Sapporo Medical University, Fujita Health University, and Kyoto University—between July 2023 and January 2025.Results
Among 118 patients (67 men, 51 women; median age 68 years, BMI 22.5), 111 had colorectal cancer. Other diagnoses included neuroendocrine tumors (n=2), recurrent rectal cancer (n=2), diverticular disease (n=1), solitary fibrous tumor (n=1), and reactive follicular hyperplasia (n=1). Surgical procedures included ileocecal resection (n=17), right hemicolectomy (n=15), left hemicolectomy (n=4), partial colectomy (n=2), sigmoidectomy (n=9), high anterior resection (n=16), low anterior resection (n=30), intersphincteric resection (n=13), Hartmann’s procedure (n=2), abdominoperineal resection (n=9), and total proctocolectomy (n=1). Median operation time and blood loss were 325 minutes, and 5 ml. There were no cases of conversion to open surgery, and Clavien-Dindo ≥3 complications occurred in 5 cases (4.2%). No 30-day mortality was reported; median hospital stay was 11 days.
Conclusion
Colorectal surgery using the Hugo RAS System appears to be safely feasible in the initial implementation phase. Further accumulation of data is necessary to evaluate its effectiveness and clinical value.