Early Hugo RAS Hernia Series Reports Feasibility, With Frequent Technical Malfunctions

A prospective evaluation followed two surgeons new to robotics during 36 robotic inguinal hernia repairs in 27 patients using the Hugo RAS system. No operation required conversion, but technical malfunctions occurred in 16 cases; the small series cannot establish safety.

Two surgeons performed 36 repairs in 27 patients.
Technical malfunctions occurred in 16 of 36 cases.
No procedures required conversion to another approach.
Small sample limits safety conclusions.

The prospective study assessed the transition from laparoscopy to robotic transabdominal preperitoneal inguinal hernia repair using Medtronic’s Hugo RAS system. Two experienced surgeons performed 36 repairs in 27 patients between November 2023 and February 2024. Investigators recorded operative measures, technical malfunctions and 30-day complications; surgeons also completed workload and technology-acceptance questionnaires.

Median docking time was 11 minutes. Median console time was 50 minutes for unilateral repairs and 100 minutes for bilateral repairs. The team recorded 33 technical malfunctions across 16 cases, but none led to conversion to open or laparoscopic surgery. Six patients had Clavien–Dindo grade 1 complications, and two had grade 2 surgical-site infections; one of the latter patients was readmitted with a urinary tract infection. All were treated with antibiotics. Mental workload reportedly declined over time for both surgeons.

The findings describe initial feasibility during implementation, not comparative effectiveness or definitive safety. With only two surgeons and 27 patients, the study is too small to assess uncommon harms or establish outcomes beyond the reported follow-up. The authors characterize technical errors as reflecting an institutional learning curve; the results do not show that robotic repair is superior to laparoscopic repair.

In practice

For surgical teams considering robotic inguinal hernia repair, this prospective series suggests that two experienced laparoscopic surgeons could complete initial Hugo RAS cases without conversion, despite technical malfunctions. It does not establish comparative benefit or definitive safety: only 27 patients were included, there were two surgeons, and follow-up for complications was 30 days. These early implementation findings alone do not support changing surgical approach or assuming similar outcomes in other teams or settings.

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Source

Surgical Endoscopy: Early implementation of the Medtronic Hugo™ RAS system for hernia repair: a prospective evaluation of the transition phase for robotics-naïve surgeons ↗

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