{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T16:12:40Z","timestamp":1793981560868,"version":"4.8.0"},"reference-count":12,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Trustworthy Autonomous Systems (TAS) Hub","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/Y009800\/1"],"award-info":[{"award-number":["EP\/Y009800\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Surg Interv Health Technologies"],"accepted":{"date-parts":[[2025,3,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the feasibility and safety of the new Hugo robotic-assisted surgery (RAS) system for robotic-assisted radical prostatectomy (RARP), describing iterative changes in our operative technique\u2014IDEAL stage 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, single-centre series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary urological unit in London, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Male patients diagnosed with clinically localised prostate cancer and suitable for RARP from February 2023 to May 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was to assess the safety of using the device without converting to the existing robotic platform (da Vinci), laparoscopy or open. Secondary outcomes assessed surgical (operative time, blood loss, time to catheter removal, complications), oncologic (surgical pathology and margin status) and early functional (continence) outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>50 patients were included in the study. No cases required conversion to an existing robotic platform, laparoscopy or open, and there were no intraoperative surgical complications. Mean age was 60 years and mean prostate-specific antigen was 12.2\u2009ng\/mL. The mean operative time was 148\u2009min and estimated blood loss was 168\u2009mL. Mean length of stay was 1.5\u2009days and mean length of catheter duration was 13 days. On final pathology, 18 patients (36%) had T3 disease and four had positive surgical margins (8%). The mean International Consultation on Incontinence Questionnaire\u2013Urinary Incontinence score for urinary continence at 3 months was 7. There were six Clavien-Dindo grade 2 complications and two Clavien-Dindo 3a complications. There were four instances of recoverable, temporary device failure. Iterative improvements were made to docking setup, use of robotic instruments and reduction in robotic arm collisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrated feasibility and the safe introduction of the Hugo RAS for RARP into an experienced robotic urological programme. Perioperative, early oncological and functional outcomes were similar to other early series. Further studies will aim to describe the learning curve with this robot and optimisation of surgical quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsit-2024-000360","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T08:41:32Z","timestamp":1743842492000},"page":"e000360","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Early clinical evaluation of the Hugo robotic-assisted surgery (RAS) for performing radical prostatectomy: an IDEAL stage 2 study"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8879-2596","authenticated-orcid":false,"given":"Andrew","family":"Shepherd","sequence":"first","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"},{"name":"The University of Adelaide Adelaide Medical School, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5087-2577","authenticated-orcid":false,"given":"Ata","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus","family":"Bruce","sequence":"additional","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Chia","sequence":"additional","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prokar","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"},{"name":"King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Challacombe","sequence":"additional","affiliation":[{"name":"Urology, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"},{"name":"King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"key":"2026011310312629000_7.1.e000360.1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/bco2.31","article-title":"Surgical robotic systems: What we have now? A urological perspective","volume":"1","author":"Almujalhem","year":"2020","journal-title":"BJUI Compass"},{"key":"2026011310312629000_7.1.e000360.2","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1177\/03915603221107855","article-title":"The new surgical robotic platform HUGOTM RAS: System description and docking settings for robot-assisted radical prostatectomy","volume":"89","author":"Totaro","year":"2022","journal-title":"Urologia"},{"key":"2026011310312629000_7.1.e000360.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f3012","article-title":"IDEAL framework for surgical innovation 1: the idea and development stages","volume":"346","author":"McCulloch","year":"2013","journal-title":"BMJ"},{"key":"2026011310312629000_7.1.e000360.4","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/bju.15829","article-title":"Idea, Development, Exploration, Assessment, Long-term follow-up study (IDEAL) Stage 1\/2a evaluation of urological procedures with the Versius robot","volume":"130","author":"Reeves","year":"2022","journal-title":"BJU Int"},{"key":"2026011310312629000_7.1.e000360.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)02543-8"},{"key":"2026011310312629000_7.1.e000360.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"2026011310312629000_7.1.e000360.7","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20041"},{"key":"2026011310312629000_7.1.e000360.8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.eururo.2022.04.029","article-title":"Robot-assisted Radical Prostatectomy with the Novel Hugo Robotic System: Initial Experience and Optimal Surgical Set-up at a Tertiary Referral Robotic Center","volume":"82","author":"Bravi","year":"2022","journal-title":"Eur Urol"},{"key":"2026011310312629000_7.1.e000360.9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1089\/end.2022.0461","article-title":"Robot-Assisted Laparoscopic Radical Prostatectomy Utilizing Hugo RAS Platform: Initial Experience","volume":"37","author":"Ragavan","year":"2023","journal-title":"J Endourol"},{"key":"2026011310312629000_7.1.e000360.10","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.euf.2023.01.008","article-title":"Outcomes of Robot-assisted Radical Prostatectomy with the Hugo RAS Surgical System: Initial Experience at a High-volume Robotic Center","volume":"9","author":"Bravi","year":"2023","journal-title":"Eur Urol Focus"},{"key":"2026011310312629000_7.1.e000360.11","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1590\/s1677-5538.ibju.2023.9902","article-title":"Implementation and outcomes of Hugo(TM) RAS System in robotic-assisted radical prostatectomy","volume":"49","author":"Alfano","year":"2023","journal-title":"Int Braz J Urol"},{"key":"2026011310312629000_7.1.e000360.12","doi-asserted-by":"crossref","DOI":"10.1007\/s11701-024-02113-3","article-title":"Medtronic's Hugo(\u2122) robotic surgery system for robot-assisted radical prostatectomy: a systematic review of current worldwide experiences","volume":"18","author":"Tehrani","year":"2024","journal-title":"J Robot Surg"}],"container-title":["BMJ Surgery, Interventions, &amp; Health Technologies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsit-2024-000360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:31:33Z","timestamp":1768329093000},"score":1,"resource":{"primary":{"URL":"https:\/\/sit.bmj.com\/lookup\/doi\/10.1136\/bmjsit-2024-000360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,4,5]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bmjsit-2024-000360"],"URL":"https:\/\/doi.org\/10.1136\/bmjsit-2024-000360","relation":{},"ISSN":["2631-4940"],"issn-type":[{"value":"2631-4940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}