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This study provides a clinical series of colorectal procedures performed with the Hugo™ RAS system. The data demonstrate the platform’s feasibility and safety across a wide spectrum of colorectal resections, including complex rectal cases. The findings support the progressive integration of the Hugo™ RAS system in minimally invasive colorectal surgery programs and contribute to the validation of its technical performance, learning curve, and perioperative outcomes in comparison with established robotic and laparoscopic platforms.
Abstract
Background: Robotic surgery represents the most advanced evolution of minimally invasive colorectal procedures. The Hugo™ Robotic-Assisted Surgery (RAS) platform by Medtronic, introduced in 2021, is a novel modular system designed to enhance accessibility and flexibility. Evidence on its application in colorectal procedures remains limited. This study aimed to evaluate the perioperative outcomes of major colorectal resections performed using the Hugo™ RAS system. Methods: A retrospective, consecutive, single-center case series was conducted on all adult patients who underwent major colorectal surgery using the Hugo™ RAS platform between May 2024 and March 2025. Primary endpoints included operative time, docking time, conversions, and intraoperative complications. Secondary endpoints included postoperative complications (classified using Clavien–Dindo), length of stay, time to bowel function recovery, postoperative pain, and readmission. All perioperative variables were standardized with defined measurement criteria, and complication severity was systematically graded. Results: Forty-four patients were included. All surgeries were completed robotically without conversion or intraoperative complications. The median docking time was 11 min, the median console time was 179 min, and the median operative time was 300 min. Four patients (9.1%) developed major complications (Clavien–Dindo III). Right colectomy anastomoses were intracorporeal, performed with a laparoscopic linear stapler through the assistant port due to absence of a robotic stapler. Conclusions: Major colorectal resections performed with the Hugo™ RAS platform were feasible and safe, with satisfactory perioperative outcomes and no conversions. These findings confirm the reproducibility of this novel robotic system in colorectal surgery. Larger prospective multicenter studies with extended follow-up are warranted to further assess long-term and oncological outcomes.