Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Comparative analysis of robot-assisted simple prostatectomy: the HUGO™ RAS system versus the DaVinci® Xi system



Robot-Assisted Simple Prostatectomy (RASP) has emerged as a promising alternative in the treatment of benign prostatic obstruction (BPO). However, there is currently a lack of comparative studies evaluating different robotic platforms for performing RASP. Therefore, we aimed to compare perioperative and functional outcomes of RASP performed using the HUGO™ RAS System versus the DaVinci® Xi System.


Forty consecutive cases of RASP performed between May 2021 and March 2023 with the HUGO™ RAS and the DaVinci® Xi at OLV Hospital (Aalst, Belgium) were included in this retrospective study. All surgeries were performed by three experienced surgeons using the same approach. Baseline characteristics, peri-operative and functional outcomes were collected and compared between the two groups.


The population was equally divided between the two groups with 20 patients in each group. There were no significant differences in preoperative patient characteristics between the two groups, except for the presence of bladder stones prior to the surgery (p = 0.03). No significant differences in total operative time and console time between the two groups were reported (p = 0.3). No cases required conversion to open surgery or additional port placement. During one case performed with the HUGO™ RAS, a malfunctioning monopolar curved shear had to be replaced. However, there was no statistically significant differences in terms of technical robotic problems between the groups (p = 0.3). There was no significant difference between the two groups in perioperative and functional outcomes (all p ≥ 0.2).


We did not observe any statistically significant difference in perioperative and functional outcomes in case of RASP performed with the HUGO™ RAS System and with the DaVinci® Xi System. These findings provide compelling support for considering the HUGO™ RAS as a promising tool for robot-assisted procedures, thereby expanding the utilization of robotics for benign conditions.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Operating room setting and port placement for RASP with the HUGO™ RAS System.
Fig. 2: Trocar placement for RASP with the HUGO™ RAS System.
Fig. 3: Trocar placement for RASP with the DaVinci® Xi System.

Data availability

Data are available from the corresponding author upon reasonable request.


  1. EAU-Guidelines-on-Non-Neurogenic-Male-LUTS-2023.

  2. Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M, et al. Robotic simple prostatectomy. J Urol. 2008;179:513–5.

    Article  PubMed  Google Scholar 

  3. Scarcella S, Castellani D, Gauhar V, Teoh JYC, Giulioni C, Piazza P, et al. Robotic-assisted versus open simple prostatectomy: results from a systematic review and meta-analysis of comparative studies. Investig Clin Urol. 2021;62:631–40.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Pandolfo SD, Del Giudice F, Chung BI, Manfredi C, De Sio M, Damiano R, et al. Robotic assisted simple prostatectomy versus other treatment modalities for large benign prostatic hyperplasia: a systematic review and meta-analysis of over 6500 cases. Prostate Cancer and Prostatic Diseases. Springer Nature; 2022.

  5. Kowalewski KF, Hartung FO, von Hardenberg J, Haney CM, Kriegmair MC, Nuhn P, et al. Robot-assisted simple prostatectomy vs endoscopic enucleation of the prostate: a systematic review and meta-analysis of comparative trials. J Endourol. 2022;8:1018–28.

    Article  Google Scholar 

  6. Bhanvadia R, Ashbrook C, Gahan J, Mauck R, Bagrodia A, Margulis V, et al. Perioperative outcomes and cost of robotic vs open simple prostatectomy in the modern robotic era: results from the National Inpatient Sample. BJU Int. 2021;128:168–77.

    Article  PubMed  Google Scholar 

  7. Farinha R, Puliatti S, Mazzone E, Amato M, Rosiello G, Yadav S, et al. Potential contenders for the leadership in robotic surgery. J Endourol. 2022;36:317–26.

    Article  PubMed  Google Scholar 

  8. Rassweiler JJ, Autorino R, Klein J, Mottrie A, Goezen AS, Stolzenburg JU, et al. Future of robotic surgery in urology. BJU Int. 2017;120:822–41.

    Article  PubMed  Google Scholar 

  9. Bravi CA, Paciotti M, Sarchi L, Mottaran A, Nocera L, Farinha R, et al. Robot-assisted radical prostatectomy with the novel Hugo robotic system: initial experience and optimal surgical set-up at a tertiary referral robotic center. Eur Urol. 2022;82:233–7.

    Article  PubMed  Google Scholar 

  10. Gallioli A, Uleri A, Gaya JM, Territo A, Aumatell J, Verri P, et al. Initial experience of robot-assisted partial nephrectomy with HugoTM RAS system: implications for surgical setting. World J Urol. 2023;41:1085–91.

  11. Bravi CA, Sarchi L, Mottaran A, Paciotti M, Farinha R, Piazza P, et al. Feasibility and optimal setting of robot-assisted partial nephrectomy with the novel “Hugo” robotic system: a pre-clinical study. Urol Video J. 2022;15:100164.

  12. Mottaran A, Paciotti M, Bravi CA, Sarchi L, Nocera L, Piro A, et al. Robot-assisted simple prostatectomy with the novel HUGOTM RAS System: feasibility, setting, and perioperative outcomes. Minerva Urol Nephrol. 2023;75:235–9.

  13. Pokorny M, Novara G, Geurts N, Dovey Z, De Groote R, Ploumidis A, et al. Robot-assisted simple prostatectomy for treatment of lower urinary tract symptoms secondary to benign prostatic enlargement: surgical technique and outcomes in a high-volume robotic centre. Eur Urol. 2015;68:451–7.

    Article  PubMed  Google Scholar 

  14. Develtere D, Mazzone E, Berquin C, Sinatti C, Veys R, Farinha R, et al. Transvesical approach in robot-assisted bladder Diverticulectomy: surgical technique and outcome. J Endourol. 2022;36:313–6.

    Article  PubMed  Google Scholar 

  15. Sarchi L, Mottaran A, Bravi CA, Paciotti M, Farinha R, Piazza P, et al. Robot-assisted radical prostatectomy feasibility and setting with the HugoTM robot-assisted surgery system. BJU Int. 2022;130:671–5.

    Article  PubMed  Google Scholar 

  16. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bravi CA, Paciotti M, Balestrazzi E, Piro A, Piramide F, Peraire M, et al. Outcomes of Robot-assisted Radical Prostatectomy with the Hugo RAS surgical system: initial experience at a high-volume robotic center. Eur Urol Focus. 2023;9:642–4.

  18. Mottaran A, Bravi CA, Sarchi L, Paciotti M, Nocera L, Piro A, et al. Robot-assisted sacropexy with the novel HUGO robot-assisted surgery system: initial experience and surgical setup at a tertiary referral robotic center. J Endourol. 2022;37:35–41.

    Article  PubMed  Google Scholar 

  19. Paciotti M, Bravi CA, Mottaran A, Nocera L, Sarchi L, Piro A, et al. Nerve‐sparing robot‐assisted radical prostatectomy with the <scp>HUGOTM</scp> robot‐assisted surgery system using the ‘Aalst technique.’ BJU Int. [Internet]. 2023 Jun; Available from:

  20. Panico G, Vacca L, Campagna G, Caramazza D, Mastrovito S, Lombisani A, et al. The first 60 cases of robotic sacrocolpopexy with the novel HUGO RAS system: feasibility, setting and perioperative outcomes. Front Surg. 2023;10:1181824.

  21. Monterossi G, Pedone Anchora L, Gueli Alletti S, Fagotti A, Fanfani F, Scambia G. The first European gynaecological procedure with the new surgical robot HugoTM RAS. A total hysterectomy and salpingo-oophorectomy in a woman affected by BRCA-1 mutation. Facts Views Vis Obgyn. 2022;14:91–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Raffaelli M, Voloudakis N, Pennestrì F, Gallucci P, Modesti C, Salvi G, et al. Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGOTM RAS. Front Surg. [Internet]. 2023 Jun;10. Available from:

  23. Raffaelli M, Gallucci P, Voloudakis N, Pennestrì F, De Cicco R, Arcuri G, et al. The new robotic platform HugoTM RAS for lateral transabdominal adrenalectomy: a first world report of a series of five cases. Updates Surg. 2023;75:217–25.

    Article  PubMed  Google Scholar 

  24. Ragavan N, Bharathkumar S, Chirravur P, Sankaran S, Mottrie A. Evaluation of Hugo RAS system in major urologic surgery: our initial experience. J Endourol. 2022;36:1029–35.

    Article  PubMed  Google Scholar 

  25. Peraire Lores M, Bravi CA, Paciotti M, Sarchi L, Nocera L, et al. Robot-Assisted Pyeloplasty With The Novel HUGO RAS System: surgical setup at a high volume robotic center. J Urol. [Internet]. 2023 Apr [cited 2023 Jun 6];209(Supplement 4). Available from:

  26. Balestrazzi E, Mottaran A, Bravi CA, Nocera L, Paciotti M, Piro A, et al. Benign Pelvic Surgery with HUGO RAS system: our experience in a tertiary referral robotic center. J Urol. [Internet]. 2023 Apr [cited 2023 Jun 6];209(Supplement 4). Available from:

  27. Mottrie A, Van Migem P, De Naeyer G, Schatteman P, Carpentier P, Fonteyne E. Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 Cases. Eur Urol. 2007;52:746–51.

    Article  PubMed  Google Scholar 

  28. Chiara Sighinolfi M, Terzoni S, Scanferla E, Paolo Bianchi P. et al. Prior robotic console expertise may improve basic skills at the new Hugo RAS simulator: results from a cohort trial and implications for skill transference across platforms. Eur Urol Open Sci.2023;53:83–9.

    Article  Google Scholar 

  29. Larkins KM, Mohan HM, Gray M, Costello DM, Costello AJ, Heriot AG. et al. Transferability of robotic console skills by early robotic surgeons: a multi-platform crossover trial of simulation training. J Robot Surg. 2022;17:859–67.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Elorrieta V, Villena J, Kompatzki Á, Velasco A, Salvadó JA. ROBOT assisted laparoscopic surgeries for nononcological urologic disease: initial experience with hugo ras system. Urology. 2023;174:118–25.

    Article  PubMed  Google Scholar 

  31. Gallagher AG, De Groote R, Paciotti M, Mottrie A. Proficiency-based progression training: a scientific approach to learning surgical skills. Eur Urol. 2022;81:394–5.

    Article  PubMed  Google Scholar 

  32. Cardi A, Palleschi G, Patruno G, Tuffu G, D’Amico FE, De Vico A, et al. Robot-assisted simple prostatectomy for treatment of large prostatic adenomas: surgical technique and outcomes from a high-volume robotic centre. World J Urol. 2023;41:515–20.

    Article  CAS  PubMed  Google Scholar 

  33. Autorino R, Zargar H, Mariano MB, Sanchez-Salas R, Sotelo RJ, Chlosta PL, et al. Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol. 2015;68:86–94.

    Article  PubMed  Google Scholar 

  34. Abou Zeinab M, Kaviani A, Ferguson E, Beksac AT, Schwen Z, Gill B, et al. Single-port transvesical versus open simple prostatectomy: a perioperative comparative study. Prostate Cancer Prostatic Dis [Internet]. 2022 [Accessed 6 Jun 2023]; Available from:

  35. Banapour P, Patel N, Kane CJ, Cohen SA, Parsons JK. Robotic-assisted simple prostatectomy: a systematic review and report of a single institution case series. Prostate Cancer Prostatic Dis. 2014;17:1–5.

    Article  CAS  PubMed  Google Scholar 

  36. Pavan N, Zargar H, Sanchez-Salas R, Castillo O, Celia A, Gallo G, et al. Robot-assisted versus standard laparoscopy for simple prostatectomy: multicenter comparative outcomes. Urology. 2016;91:104–10.

    Article  PubMed  Google Scholar 

  37. Ragavan N, Bharathkumar S, Chirravur P, Sankaran S. Robot-assisted laparoscopic radical prostatectomy utilizing Hugo RAS platform: initial experience. J Endourol. 2023;37:147–50.

    Article  PubMed  Google Scholar 

Download references


The authors would like to thank Jesus Dominguez for his contribution and Olivier Mahieu for his constant support.

Author information

Authors and Affiliations



EB: methodology, investigation, data collection, formal analysis, writing—original draft. MP: conceptualization, investigation, writing—review & editing, data curation, visualization. CAB: investigation, writing—review & editing. FP: investigation, validation. GS: investigation, validation. MT: investigation, validation. MPL: investigation, validation. AP: investigation, validation. NF: investigation, validation. SR: investigation, validation. CC-R: investigation, validation. MB: investigation, validation. RDG: supervision, validation. GDN: review & editing, data curation, visualization, supervision. AM: supervision, validation.

Corresponding author

Correspondence to E. Balestrazzi.

Ethics declarations

Competing interests

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. The authors declare that this study has been conducted according to the ethical guidelines of the Declaration of Helsinki. All authors read and approved the final version of the manuscript.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balestrazzi, E., Paciotti, M., Piro, A. et al. Comparative analysis of robot-assisted simple prostatectomy: the HUGO™ RAS system versus the DaVinci® Xi system. Prostate Cancer Prostatic Dis (2023).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI:


Quick links