{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:12:48Z","timestamp":1790737968592,"version":"4.1.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002957","name":"Technische Universit\u00e4t Dresden","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002957","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Robot-assisted surgery is increasingly preferred. New systems such as the Hugo\u2122RAS enter the market, offering different pricing and modular architecture. While daVinci systems dominate U.S. practice, the HugoRAS system is undergoing early implementation. Understanding non-surgical, patient-independent time (NonSPIT)\u2014a major driver of cost and efficiency\u2014is crucial for institutions considering adoption. We conducted a prospective, single-center study in Germany, comparing perioperative times of robotic pelvic procedures (RPP) using newly introduced HugoRAS and preestablished daVinci Xi, and retrospectively of open pelvic procedures (OPP). NonSPIT, defined as setup, docking, undocking, and system cleanup, was recorded and analyzed with respect to personnel experience. The resulting costs were estimated. 167 RPP using HugoRAS (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009144) and Xi (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200923) were included and supplemented with 20 historical OPP. NonSPIT accounted for 40.0% (HugoRAS) and 36.7% (Xi) of total procedure time, compared to 31% in OPP. HugoRAS required 13 more minutes of NonSPIT than Xi (94.3 vs. 81.6\u00a0min;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05\u2013OPP: 68.4\u00a0min). This overall disadvantage was nullified after 10\u201315 cases per scrub nurse. 77.1% of NonSPIT difference was caused by setup, where RPP showed longer preparation times than OPP (45.1 and 33.5\u00a0min vs. 27.4\u00a0min). HugoRAS setup was slower than Xi for unexperienced (48.0 vs. 33.5\u00a0min;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01) and experienced teams (44.5 vs. 33.5\u00a0min;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). The projected additional time costs of NonSPIT in HugoRAS RPP amounts to $865.55 and $1325.95 per procedure compared to Xi and OPP, respectively. HugoRAS\u2019 cost of learning is estimated at $7017.87 per nurse until efficiency of an established Xi system is achieved. In the U.S. context, HugoRAS may initially be less time-efficient than daVinci Xi. However, this gap closes after approximately 15 procedures, leaving behind only a small disadvantage in system preparation and making HugoRAS an economical alternative\u2014particularly given its lower per-case instrumentation costs.\n                  <\/jats:p>","DOI":"10.1007\/s11701-025-02731-5","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:34:59Z","timestamp":1757093699000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of non-surgical OR time on efficiency and costs with Hugo\u2122 RAS"],"prefix":"10.1007","volume":"19","author":[{"given":"Christopher","family":"Hirtsiefer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Herout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif","family":"Mehralivand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Oelkers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Franz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Baunacke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"2731_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2024.08.004","author":"N Pyrgidis","year":"2024","unstructured":"Pyrgidis N, Volz Y, Ebner B et al (2024) Evolution of robotic urology in clinical practice from the beginning to now: results from the GRAND study register. 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Authors C.H. and M.B. have received consultant honoraria from Medtronic, Minneapolis, MN, USA. R.H. received a scholarship from Intuitive Surgical (via the DGRU) for 3-day training course in robotic surgery. C.H. has received reimbursement of congress costs by Intuitive Surgical, Sunnyvale, CA, USA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Dresden (17.08.2023\/No. BO-EK-273062023).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"565"}}