{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:49:48Z","timestamp":1792180188963,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To determine optimal port placement for retroperitoneal robot\u2010assisted radical nephroureterectomy (RANU) using the Hugo robot\u2010assisted surgery system (HRS) and to compare perioperative outcomes and arm interference between transperitoneal and retroperitoneal approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 21 patients who underwent RANU for upper tract urothelial carcinoma with HRS at our institution between 2023 and 2025 via a transperitoneal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) or retroperitoneal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) approach. For clinical retroperitoneal RANU, four robotic ports were placed 3\u2009cm lateral to the erector spinae and spaced 8\u2009cm medially. We compared patient demographics, perioperative metrics, and the rates of arm interference and system\u2010caused errors from log data. Continuous variables were analyzed using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test, whereas categorical variables were analyzed using the chi\u2010squared test or Fisher's exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Total operative, console, and dissection times; blood loss; and transfusion and complication rates were comparable between approaches. One transperitoneal case required conversion to da Vinci because of HRS malfunction. The median number of removed lymph nodes was significantly lower in the retroperitoneal group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049). The time from incision to roll\u2010in was shorter in the transperitoneal group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), whereas the time from roll\u2010in to console start favored the retroperitoneal approach (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Arm\u2010interference errors were significantly less common for the retroperitoneal approach (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), whereas the frequency of system\u2010caused errors did not differ between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Retroperitoneal HRS\u2010RANU was feasible in our cohort and may reduce arm interference; larger studies are needed to confirm this.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70250","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T23:54:10Z","timestamp":1770767650000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Initial Experience With Robot\u2010Assisted Nephroureterectomy Using the Hugo Robot\u2010Assisted Surgery System via a Retroperitoneal Approach: Clinical Comparison With the Transperitoneal Approach"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0344-5892","authenticated-orcid":false,"given":"Shuichi","family":"Morizane","sequence":"first","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yamane","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoma","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriya","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuya","family":"Hikita","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine Tottori University  Yonago Tottori 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