Use of the Medtronic Hugo Robot-Assisted Surgery (RAS) System in Urogynecology: A Safety and Feasibility Study of the First 100 Procedures

Abstract

INTRODUCTION: This study evaluates the safety and feasibility of the Medtronic Hugo robot-assisted surgery (RAS) system in gynecological and urogynecological procedures. Through a retrospective analysis of prospectively collected data from the first 100 surgeries performed at Apollo Hospitals Chennai, we aim to provide insights into the system's effectiveness, including outcomes, complications, and overall surgical efficiency in major gynecological and urogynecological operations. METHODS: A single experienced robotic surgeon conducted the surgeries, including hysterectomies (n=66). Other common procedures performed were for pelvic organ prolapse (n=12), vesicovaginal fistula (VVF) (n=8), and ovarian cystectomies (n=8). Data on patient demographics, peri and postoperative outcomes, complications, and 30-day readmission rates were collected and analyzed. RESULTS: All surgeries were completed without open conversions. One patient experienced a sigmoid colon injury intraoperatively due to severe adhesions from endometriosis; the injury was repaired intraoperatively, and the patient had an uneventful recovery. No patients experienced Clavien-Dindo grade 2 postoperative complications, and there were no readmissions within 30 days. The median docking time was 10.4 ± 2.2 minutes, console time was 60.5 ± 19.7 minutes, and hospital stays ranged from 1 to 4 days, all within acceptable ranges. CONCLUSIONS: The Medtronic Hugo RAS system demonstrates safety and feasibility in major urogynecology procedures, suggesting its potential as a valuable addition to robotic surgical platforms.