Intraoperative Performance of DaVinci Versus Hugo RAS During Radical Prostatectomy: Focus on Timing, Malfunctioning, Complications, and User Satisfaction in 100 Consecutive Cases (the COMPAR-P Trial)

The present prospective study compared 50 versus 50 unselected patients who underwent robotic prostatectomy performed with the DaVinci versus Hugo RAS system. Although more malfunctioning/troubleshooting events were recorded during Hugo RAS cases, the surgery outcomes, including the occurrence of intraoperative complications, were not statistically different. Longer operative time was recorded for Hugo RAS cases, likely explained by the meticulous care applied in the surgery due to the use of the novel platform. Still, the prospect of improvement within a relatively low number of procedures was evident. All these findings can contribute to the adoption of this new platform. The Hugo RAS and DaVinci Xi systems are used for performing robot-assisted radical prostatectomy (RARP). This study aims to compare these two platforms providing granular and comprehensive data on their intraoperative performance. The Comparison of Outcomes of Multiple Platforms for Assisted Robotic surgery—Prostate (COMPAR-P) trial is a prospective post-market study (clinicaltrials.org NCT05766163). Enrollment began in March 2023, allocating patients to DaVinci or Hugo RAS for RARP, without selection criteria, for up to 50 consecutive cases. Two experienced console surgeons performed the procedures, following the same technique. Evaluation focused on timing, learning curves, malfunctioning events, complications, and users’ satisfaction, using standard statistical methods, including the cumulative summation analysis (CUSUM) for the learning curve assessment. Fifty patients each were enrolled for DaVinci (DV-RARP) and Hugo RAS (H-RARP) RARP. Baseline features were balanced. DV-RARP showed significantly shorter “setup” and “console” phase durations than H-RARP (37 vs 55 min and 97 vs 126 min, respectively, p