{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:01:18Z","timestamp":1784588478935,"version":"3.55.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001631","name":"University College Dublin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001631","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>The Hugo RAS (Medtronic) represents a growing alternative to the DaVinci robotic platform, featuring a distinctive modular arm-cart design that may pose challenges for surgeons transitioning from established systems. Arm-cart positioning, restricted assistant access, and risk of personnel injury have been identified as barriers to adoption. Following FDA approval for urological procedures in 2025, optimizing a standardized, ergonomic set-up for upper tract cases is essential to facilitate broader uptake. A retrospective analysis of a prospectively maintained database was performed at a single robot-na\u00efve institution. All patients undergoing Hugo RAS upper tract procedures \u2014 including robot-assisted partial nephrectomy (RAPN), radical nephrectomy, pyeloplasty, and nephroureterectomy \u2014 from January 2024 to May 2025 were included. Perioperative outcomes, set-up times, intraoperative events, and arm-cart repositioning requirements were recorded. A unilateral, four posterior arm-cart configuration with a linear or \u201cW\u201d port arrangement was employed in all. 54 upper tract procedures were performed across two expert robotic surgeons. No cases required intraoperative arm-cart repositioning. Median set-up time for RAPN improved by 8\u00a0min between the first and last quartile of cases (15 to 7\u00a0min). One additional port was required in a nephroureterectomy case. One minor assistant injury occurred. One case required open conversion for vascular bleeding. RENAL nephrometry scores ranged from 4 to 11 (median 7), with 44% classified as moderate-to-high complexity. A unilateral posterior arm-cart configuration with linear port placement is feasible, reproducible, and familiar to DaVinci-experienced surgeons, improving ergonomics, workflow, and set-up efficiency for Hugo RAS upper tract procedures.<\/jats:p>","DOI":"10.1007\/s11701-026-03563-7","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:23:04Z","timestamp":1784539384000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alternative set up strategies for upper tract robotic surgery with the Hugo RAS \u2013 experience from an early adopter institution"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9171-0491","authenticated-orcid":false,"given":"R. 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B.","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"3563_CR1","unstructured":"Medtronic (2021) Medtronic Hugo\u2122 Robotic-Assisted Surgery System Receives European CE Mark Approval 2021 [Available from: https:\/\/news.medtronic.com\/2021-10-11-Medtronic-Hugo-TM-Robotic-Assisted-Surgery-System-Receives-European-CE-Mark-Approval"},{"issue":"1","key":"3563_CR2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1111\/bju.16166","volume":"133","author":"F Prata","year":"2024","unstructured":"Prata F, Ragusa A, Anceschi U, Iannuzzi A, Tedesco F, Cacciatore L et al (2024) Three-arms off-clamp robot-assisted partial nephrectomy with the new Hugo robot-assisted surgery system. BJU Int 133(1):48\u201352","journal-title":"BJU Int"},{"key":"3563_CR3","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.urology.2024.06.052","volume":"192","author":"GM Andrade","year":"2024","unstructured":"Andrade GM, Lau C, Olivares R, Duarte IK, Teles SB, Gavassa FP et al (2024) Implementation of Robot-assisted Urologic Surgeries Using Hugo RAS System in a High-volume Robotic \u201cDa Vinci Xi\u201d Center: Outcomes and Initial Experience. Urology 192:44\u201351","journal-title":"Urology"},{"issue":"1","key":"3563_CR4","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1007\/s11701-024-02113-3","volume":"18","author":"MS Tehrani","year":"2024","unstructured":"Tehrani MS, Shepherd A, Challacombe B (2024) Medtronic\u2019s Hugo(\u2122) robotic surgery system for robot-assisted radical prostatectomy: a systematic review of current worldwide experiences. J Robot Surg 18(1):352","journal-title":"J Robot Surg"},{"issue":"1","key":"3563_CR5","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1007\/s11701-025-02818-z","volume":"19","author":"S Toubasey","year":"2025","unstructured":"Toubasey S, Tehrani MS, Shepherd A, Beetge N, Thakur A, Muralitharan M et al (2025) A systematic review of global experiences with Medtronic\u2019s Hugo\u2122 robotic system for robot-assisted partial nephrectomy. J Robot Surg 19(1):654","journal-title":"J Robot Surg"},{"issue":"9","key":"3563_CR6","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.3390\/jpm13091372","volume":"13","author":"F Prata","year":"2023","unstructured":"Prata F, Raso G, Ragusa A, Iannuzzi A, Tedesco F, Cacciatore L et al (2023) Robot-Assisted Renal Surgery with the New Hugo Ras System: Trocar Placement and Docking Settings. J Pers Med 13(9):1372","journal-title":"J Pers Med"},{"issue":"4","key":"3563_CR7","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1007\/s00345-023-04336-9","volume":"41","author":"A Gallioli","year":"2023","unstructured":"Gallioli A, Uleri A, Gaya JM, Territo A, Aumatell J, Verri P et al (2023) Initial experience of robot-assisted partial nephrectomy with Hugo\u2122 RAS system: implications for surgical setting. World J Urol 41(4):1085\u201391","journal-title":"World J Urol"},{"issue":"4","key":"3563_CR8","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1089\/end.2023.0598","volume":"38","author":"S Rebuffo","year":"2024","unstructured":"Rebuffo S, Ticonosco M, Ruvolo CC, Pissavini A, Balestrazzi E, Paciotti M et al (2024) Robot-Assisted Pyeloplasty with HUGO\u2122 Robotic System: Initial Experience and Optimal Surgical Set-Up at a Tertiary Referral Robotic Center. J Endourol 38(4):323\u201330","journal-title":"J Endourol"},{"issue":"6","key":"3563_CR9","doi-asserted-by":"publisher","first-page":"859","DOI":"10.23736\/S2724-6051.25.06067-7","volume":"77","author":"A Ragusa","year":"2025","unstructured":"Ragusa A, Prata F, Iannuzzi A, Tedesco F, Pira M, Civitella A et al (2025) Robot-assisted pyeloplasty with the New Hugo\u2122 RAS: step-by-step surgical settings and technique. Minerva Urol Nephrol 77(6):859\u201366","journal-title":"Minerva Urol Nephrol"},{"issue":"3","key":"3563_CR10","first-page":"303","volume":"76","author":"E Garc\u00eda Rojo","year":"2024","unstructured":"Garc\u00eda Rojo E, Hevia Palacios V, Brime Menendez R, Feltes Ochoa JA, Justo Quintas J, Lista Mateos F et al (2024) Da Vinci and Hugo RAS platforms for robot-assisted partial nephrectomy: a preliminary prospective comparative analysis of the outcomes. Minerva Urol Nefrol 76(3):303\u201311","journal-title":"Minerva Urol Nefrol"},{"key":"3563_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolvj.2023.100255","volume":"21","author":"F Chierigo","year":"2024","unstructured":"Chierigo F, Caviglia A, Cellini V, Maltzman O, Olivero A, Barbieri M et al (2024) Transperitoneal and retroperitoneal robot-assisted partial nephrectomy with the Hugo\u2122 RAS system: video instructions and initial experience from a tertiary care referral centre. Urology Video J 21:100255","journal-title":"Urology Video J"},{"issue":"4","key":"3563_CR12","first-page":"110","volume":"19","author":"A Bobrowski","year":"2025","unstructured":"Bobrowski A, Wu W, Angeles C, Czajkowski S, Lee JY (2025) Robotic-assisted partial nephrectomy using the Hugo(TM) robotic-assisted surgery platform initial experience and insights. 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Urologia 91(2):372\u20138","journal-title":"Urologia"},{"issue":"12","key":"3563_CR15","doi-asserted-by":"publisher","first-page":"706.e27","DOI":"10.1016\/j.urolonc.2025.07.023","volume":"43","author":"F Prata","year":"2025","unstructured":"Prata F, Basile S, Tedesco F, Ragusa A, Iannuzzi A, De Giuseppe A et al (2025) Robot-assisted partial nephrectomy with the Hugo\u2122 RAS system: perioperative outcomes from a single-center cohort including moderate-to-highly complex renal masses. Urol Oncol 43(12):706.e27-.e33","journal-title":"Urol Oncol"},{"issue":"10","key":"3563_CR16","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1089\/end.2024.0287","volume":"38","author":"S Morizane","year":"2024","unstructured":"Morizane S, Hussein AA, Yamane H, Shimizu R, Nishikawa R, Kimura Y et al (2024) Initial experience and surgical setup of robot-assisted nephroureterectomy using the Hugo robot-assisted surgery system. J Endourol 38(10):1004\u201312","journal-title":"J Endourol"},{"issue":"1","key":"3563_CR17","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-025-02745-z","volume":"19","author":"KP Nyein","year":"2025","unstructured":"Nyein KP, McGuire BB, Huang E, Condron C, Schmutz JB (2025) Exploring the effects of closed-console vs. open-console robotic-assisted surgery systems on team dynamics in the operating room. 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The XYZ Research Ethics Committee has confirmed that no ethical approval is required.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants for use of their images to be included in the study.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"663"}}