Surgical Technique and Perioperative and Postoperative Outcomes for Robot-assisted Radical Cystectomy with Intracorporeal Urinary Diversion Performed with the Hugo RAS Robotic Platform: First Large Case Series by the European Association of Urology Robotic Urology Section Scientific Working Group
Por:
Scuderi, S, Rautiola, J, Sighinolfi, C, Prata, F, Bogdanovic, D, Tedesco, F, Degroote, R, Barletta, F, D'Hondt, F, Lambert, E, Palou, J, Gallioli, A, Basile, G, Cannoletta, D, Pellegrino, F, Falagario, U, Carrieri, G, Gandaglia, G, Briganti, A, Montorsi, F, Papalia, R, Aly, M, Akre, O, Rocco, B, Mottrie, A, Larcher, A, Breda, A, Wiklund, P
Publicada:
1 mar 2026
Ahead of Print:
1 feb 2026
Resumen:
Background and objective: The Hugo RAS robotic platform has shown promising results for urological surgical procedures, but there is a lack of data on robot-assisted radical cystectomy (RARC). Our aim was to describe the surgical technique for RARC performed with the Hugo RAS robot and to assess perioperative and postoperative outcomes. Methods: We identified 29 patients who underwent RARC with lymph node dissection and intracorporeal urinary diversion (IUD) performed with a Hugo RAS robot at five centers between February 2023 and June 2024. An intraoperative video was recorded to show the surgical technique. Data for intraoperative and 90-d postoperative complications were collected according to the European Association of Urology recommendations. Key findings and limitations: In the cohort of 29 patients, 21 (72%) were male and 19 (68%) had a muscle-invasive tumor on clinical evaluation. Nerve-sparing surgery was performed in four men and pelvic organ-preserving procedures in six women. Orthotopic diversion was performed in 14 patients (48%). The median hospital stay was 7 d and median operative time was 279 min. Four patients (14%) had intraoperative complications and 12 (41%) had an any-grade postoperative complication, of which three (10%) were of high grade (Clavien-Dindo grade >2). The most common complications were urinary tract infection (n = 9, 31%), ileus (n = 6, 21%), and anemia requiring transfusion (n = 4, 14%). Conclusions and clinical implications: Our results demonstrate the safety and feasibility of the Hugo RAS robotic platform in performing RARC with IUD. Perioperative and postoperative outcomes were comparable to those reported for established robotic systems, without the need for platform-specific modifications. Patient summary: We looked at bladder cancer surgery using the new Hugo RAS robotic system in a group of 29 patients. The surgery was safe and effective, with outcomes similar to those seen with more established robotic systems. Our results suggest that this new robot is a reliable surgical option for bladder removal. (c) 2026 Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
Filiaciones:
Scuderi, S:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Rautiola, J:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Sighinolfi, C:
Univ Cattolica Sacro Cuore, IRCCS A Gemelli Hosp, Urol Unit, Rome, Italy
Prata, F:
Fdn Pol lin Univ Campus Biomed, Dept Urol, Rome, Italy
Bogdanovic, D:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Tedesco, F:
Fdn Pol lin Univ Campus Biomed, Dept Urol, Rome, Italy
Degroote, R:
Azorg Hosp, Aalst, Belgium
ORSI Acad, Ghent, Belgium
Barletta, F:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Azorg Hosp, Aalst, Belgium
ORSI Acad, Ghent, Belgium
D'Hondt, F:
Azorg Hosp, Aalst, Belgium
ORSI Acad, Ghent, Belgium
Lambert, E:
Azorg Hosp, Aalst, Belgium
ORSI Acad, Ghent, Belgium
Palou, J:
Univ Autonoma Barcelona, Dept Urol, Fdn Puigvert, Barcelona, Spain
Gallioli, A:
Univ Autonoma Barcelona, Dept Urol, Fdn Puigvert, Barcelona, Spain
Basile, G:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Univ Autonoma Barcelona, Dept Urol, Fdn Puigvert, Barcelona, Spain
Cannoletta, D:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Univ Autonoma Barcelona, Dept Urol, Fdn Puigvert, Barcelona, Spain
Pellegrino, F:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Falagario, U:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Univ Foggia, Dept Urol & Renal Transplantat, Foggia, Italy
Carrieri, G:
Univ Foggia, Dept Urol & Renal Transplantat, Foggia, Italy
Gandaglia, G:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Briganti, A:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Montorsi, F:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Papalia, R:
Fdn Pol lin Univ Campus Biomed, Dept Urol, Rome, Italy
Aly, M:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Akre, O:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Rocco, B:
Univ Cattolica Sacro Cuore, IRCCS A Gemelli Hosp, Urol Unit, Rome, Italy
Mottrie, A:
Azorg Hosp, Aalst, Belgium
ORSI Acad, Ghent, Belgium
Larcher, A:
Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Gianfranco Soldera Prostate Canc Lab, Milan, Italy
Breda, A:
Univ Autonoma Barcelona, Dept Urol, Fdn Puigvert, Barcelona, Spain
Wiklund, P:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden
Green Submitted, Green Published, gold
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