Robot-assisted video-endoscopic inguinal lymphadenectomy with the Hugo™ RAS System: surgical set-up and initial experience

The Hugo™ RAS system is gaining prominence in the field of urologic robotic surgery. To date, no study has described robot-assisted video-endoscopic inguinal lymphadenectomy (RAVEIL) using this system. Therefore, the aim of the study is to evaluate the feasibility and safety of the procedure, focusing on surgical set-up and preliminary results. A total of seven procedures in five patients with penile cancer were prospectively included. Baseline patient characteristics, intra- and post-operative surgical outcomes were recorded. Overall, four patients (80%) had negative clinical N-staging (cN0). Median (IQR) operative time was 90 (85-97.5) minutes, with a median (IQR) of 8 (8-9) lymph node yield per procedure. One post-operative complication, a lymphocele requiring percutaneous drainage (Clavien-Dindo 3a), was reported. Median (IQR) hospital stay was 3 (3-3.5) days and the median (IQR) time to drain removal was 8 (6.5-10) days. This is the first case series demonstrating the safety and feasibility of RAVEIL using the Hugo™ RAS system. The surgical configuration described may serve as a valuable reference standard for RAVEIL with this robotic platform and help novel adopters in implementing the platform in another surgical scenario.