Early implementation and feasibility of Hugo RAS system-assisted right colectomy for right-sided colon cancer: an exploratory propensity score-matched comparison with the da Vinci surgical system.

BACKGROUND

Clinical evidence for robot-assisted right colectomy (RARC) using the Hugo RAS system remains limited. We aimed to describe the early implementation experience of Hugo-assisted RARC and to preliminarily compare short-term outcomes with those of the da Vinci system.

METHODS

This dual-center retrospective cohort study included 74 patients who underwent RARC with complete mesocolic excision for right-sided colon cancer between September 2019 and April 2025. Patients who underwent multivisceral resections for non-colorectal disease or had multiple colorectal cancers were excluded. Propensity score matching (PSM) was applied at a 1:1 ratio, and the perioperative, postoperative, and pathological outcomes of 22 patients in each group treated using Hugo or da Vinci system were compared.

RESULTS

The baseline characteristics were more balanced after matching, although a slight imbalance remained. The console time (146 vs. 132 min; P = 0.549) and estimated blood loss (5 vs. 0 mL; P = 0.299) were comparable, but the total surgical duration was significantly longer for the Hugo group (286 vs. 246 min; P = 0.015). The pathological outcomes, including resection margins and harvested lymph nodes, were similar between groups. No conversion to open surgery, anastomotic leakage, reoperation, 30-day readmission, or mortality occurred in either group. One Clavien-Dindo grade IIIa complication unrelated to the surgery occurred in the da Vinci group. The postoperative hospital stay was comparable between the groups.

CONCLUSIONS

The early implementation of RARC using Hugo appeared feasible and yielded acceptable short-term perioperative and pathological outcomes in a limited matched cohort. Although the total surgical duration was longer with the Hugo RAS system than with the da Vinci system, other short-term outcomes were broadly similar between the groups and should be interpreted as preliminary. Further multicenter prospective studies are needed to validate these findings and evaluate long-term oncological outcomes.