Comparison of perioperative outcomes of robot-assisted radical prostatectomy among the da Vinci, hinotori, and Hugo robot-assisted surgery systems.

Abstract

In recent times, innovative surgical robotics have emerged and gained widespread adoption. This study aimed to compare the perioperative outcomes associated with robot-assisted radical prostatectomy (RARP) using three different robotic surgical systems: da Vinci surgical system (DVSS), hinotori surgical robot system (HSRS), and Hugo robot-assisted surgery system (HRASS). Our study involved a retrospective analysis of clinical data from 149 individuals who received RARP from 2022 to 2024, utilizing the DVSS (n = 81), HSRS (n = 52), and HRASS (n = 16). We compared patient characteristics and perioperative outcomes, including complications, console time, and time to console start (i.e., port placement and docking time) among these groups. The Fisher's exact test was used to test categorical variables and Kruskal-Wallis test were used to test continuous variables. Linear model was used to measure the learning rate. The DVSS, HSRS, and HRASS significantly differed in terms of the median operative time (348, 343, 279 min, respectively, p < 0.001); median port placement time (25, 23, 22 min, respectively, p = 0.136); and median docking time (7, 13, 15 min, respectively, p < 0.001). The time to console was shorter with DVSS than with the HSRS and HRASS (p = 0.024). The incidence of perioperative complications was comparable across all three groups, with no statistically significant variations. Compared to other systems, the DVSS showed superior efficiency in both docking and transitioning to console surgery. Although surgeon bias cannot be ruled out in this study, RARP could be safely performed in clinical practice using any of these three models.