Hugo Robot, what is it and the 12 innovations of the surgical system (in the urology field)

In this article we will talk about Hugo Robot, the latest groundbreaking innovation in robotic surgery for the urology field.

What is Hugo Robot?

The Hugo robot, also called Hugo RAS system, is a surgical robotic system developed by Medtronic. It’s purpose is to assist surgeons in performing minimally invasive procedures for urological operations (but it can be used for other specialties as well, such as gynecology, colorectal and general surgery).

Hugo provides enhanced visualization, precision and control during surgeries, and it’s equipped with advanced features, including artificial intelligence capabilities.

Its design aims to improve surgical outcomes, reduce complications, and enhance the overall patient experience.

From the Da Vinci to Hugo Robot

Ever since the Da Vinci robot revolutionized robotic surgery, many other innovations have been introduced in the surgical field. The Hugo RAS system is one of them, and one of the most noteworthy at that.

Hugo Robot was developed as a modular robotic platform featuring four independent robotic arms, allowing the adaptation of surgical strategies for highly customized procedures.

Hugo Robot is made of a console, a system tower, and four independent robotic arms, which are very extensible thanks to their 6 joints. The combination of all these elements allows the surgeons to perform complex procedures with greater control and precision while reducing patient trauma, pain and recovery time.

So far the Hugo RAS system, at least in the urology field, has been employed for radical and simple protatectomies, radical cystectomies, radical and partial nephrectomies, and pyeloplasty procedures.

How does the Hugo Robot work?

The use of Hugo involves the surgeon sitting at an open console that displays a high-definition 3D view of the patient’s body, and allows them to precisely control the robotic arms and instruments.

Once the surgeon takes place in the chair in front of the console, he can control the robotic arms and the energy supply through the pedals.

The master clutch allows the repositioning of the manipulators. A switch pedal is located laterally to shift between the 3rd and the 4th arm. The endoscope control pedal allows for repositioning of the endoscope.

To control the Hugo Robot, the surgeon handles what are called the pistol grip manipulators, with infrared contact sensors enable the robotic movement.

On the lower part of each manipulator there’s a clutch button. It can be pushed to reposition the manipulator itself. On the top there are forward and backward buttons used to control the robotic endo-stapler.

The operating surgeon has two monitors that he can watch:

A passive 3D-HD screen to see the surgical screen using 3D glasses.
A touchscreen interactive display to assign the hooked instruments to the right or left hand, to set the motion scaling, and select visual filters and camera rotation. The touchscreen is positioned on the right side of the 3D screen.

Over the 3D-HD monitor is installed a head tracking system. It is a vision device that reveals the alignment between reflective markers on the 3D glasses and the surgical monitor, enabling the robotic control. If the surgeon looks at a point different from the surgical field, thus losing the alignment, the robotic control is disabled.

The Hugo Robot components in detail

Now let’s take a deeper look into the Hugo Robot’s components, starting from the System Tower.

The System Tower

Hugo’s System Tower houses computers, the power management system, and a backup battery in the bottom part. In the middle there are the electro surgical generator (Covidien AG) and the 3D-HD vision system.

The System Tower bridges between the console and the arm through singe anti-crushing cables. It allows the surgeon to control the movements of the robotic arms.

It can also be used without the surgeon console to power up to four arms for standalone manual control at the bedside, or by itself for standard laparoscopic visualization and electrosurgery.

The robotic arms

The Hugo RAS system’s robotic arms are the main active component that physically replace the surgeon’s hands in the operating field. They represent a relevant evolution due to the wide range of positioning provided by the six different joints. Each arm can be raised or lowered on the cart column for vertical positioning.

Prior to approaching the patient, the laser alignment unit must be set in parallel with the operative table and oriented with the patient’s body to create a frame of reference in the space for the Hugo Robot.

After this process, each robotic arm measures, in a digital space, the angle of approach to the patient. By pushing the apposite buttons, the arms can be unfolded, extended, rotated, and hooked to the robotic trocar.

Hugo Robot’s advantages

The Hugo Robot system provides many advantages, both for the patient and for the surgeon.

On the surgeon’s side, the system offers greater control, precision, and dexterity, which leads to improved outcomes, enhanced ergonomics and a reduced number of surgical errors. Thanks to its modularity, the Hugo Robot can help surgeons in performing complex procedures with ease.

On the patient’s side, the system has proved to reduce postoperative pain, blood loss, and hospital stay. It also improved cosmetic outcomes and overall quality-of-life.

Other general advantages provided by the Hugo system include:

More ergonomic trocar position.
Superior dexterity.
Superior range of motion.
Precise instrument control.
High definition three-dimensional (3D) visualization.
Haptic feedback.
Remote telemetry.
A larger working space for bedside assistant.
Cost-effectiveness for individual procedures.

The system also includes advanced features related to safety:

Collision avoidance.
Force sensing.
Automatic joint lockout.

The future of Hugo

There’s no doubt that the Hugo RAS system represents a cutting-edge revolution on the surgical field. What the future holds for us could be even more advanced surgical systems that will potentially benefit both the surgeons and the patients more and more.

Since the Hugo RAS system is one of the newest robotic generations launched on the field, there’s still a lack of comprehensive clinical data about it. However, it’s possible that the Hugo Robot will be a starting point for even greater innovations.

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