King's College London, London, UK.
Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Robot Surg. 2024 Sep 28;18(1):352. doi: 10.1007/s11701-024-02113-3.
Urology's pioneering role in surgical innovations, from cystoscopy to laparoscopic surgery, culminated in the twenty-first-century advent of robotic surgery. The dominant da Vinci system faced new competition following its 2019 patent expiration. Medtronic's Hugo system emerged. Its growing global adoption, especially in robot-assisted radical prostatectomy (RARP), necessitates a systematic review, evaluating safety, feasibility, and comparison with established systems. A comprehensive search identified eligible studies of the Hugo robotic platform for RARP, presenting their current experiences. Following systematic screening, quality of eligible studies was assessed using ROBINS-I. Results then underwent a narrative synthesis. This systematic review analysed 19 eligible studies, consisting of 9 comparative and 10 single arm studies. Due to the non-randomised nature of the studies, a moderate risk of bias was concluded in most. On account of the high heterogeneity between studies, a narrative synthesis of data was enacted; categorised into themes relating to operative timings, transfer of skills, patient demographics, plus safety and feasibility. Eligible studies demonstrated the promise of the Hugo platform within these themes, in comparison to currently available platforms. Despite a paucity of high-quality randomised controlled trials, available evidence indicates Hugo as a promising, safe alternative for RARP. Positive experiences across diverse centres and surgeons revealed minimal differences in surgical outcomes compared to the established da Vinci system, fostering global Hugo adoption. Despite evidence demonstrating Hugo safety and comparability, the review underscores the scarcity of high-quality evidence, attributing it to early stage implementation challenges.
泌尿科在手术创新方面发挥了先驱作用，从膀胱镜检查到腹腔镜手术，最终在 21 世纪迎来了机器人手术的时代。达芬奇系统在 2019 年专利到期后面临新的竞争。美敦力的 Hugo 系统应运而生。随着它在全球范围内的应用越来越多，特别是在机器人辅助根治性前列腺切除术（RARP）中，有必要进行系统评价，评估其安全性、可行性，并与已建立的系统进行比较。全面搜索确定了 Hugo 机器人平台在 RARP 中的合格研究，并展示了他们目前的经验。经过系统筛选，使用 ROBINS-I 评估合格研究的质量。然后对结果进行叙述性综合。这项系统评价分析了 19 项合格研究，其中包括 9 项比较研究和 10 项单臂研究。由于研究的非随机性，大多数研究都存在中度偏倚风险。由于研究之间存在高度异质性，因此对数据进行了叙述性综合；分为与手术时间、技能转移、患者人口统计学以及安全性和可行性相关的主题。合格研究在这些主题中展示了 Hugo 平台的潜力，与当前可用的平台相比。尽管缺乏高质量的随机对照试验，但现有证据表明 Hugo 是 RARP 的一种有前途、安全的替代方案。来自不同中心和外科医生的积极经验表明，与已建立的达芬奇系统相比，手术结果的差异极小，促进了全球 Hugo 的采用。尽管有证据表明 Hugo 的安全性和可比性，但该综述强调了高质量证据的缺乏，这归因于早期实施的挑战。
