A comparative outcome of feasibility and outcomes in robot assisted radical prostatectomy on Hugo RAS Medtronic and Da Vinci system: A single center initial experience in Asia Pacific

Prostate cancer is the second most common cancer in male population in India. Robotic-assisted radical prostatectomy is treatment of choice for prostate cancer. We here compare 24 cases each done by Da Vinci Si system and Hugo RAS system by a single surgeon for localized prostate cancer between June 2022 and September 2023 in Sir Ganga Ram Hospital, Delhi. Preoperative data included basic demographic data, PSA levels, MRI and Gleason grade. Variables assessed during procedure were operative duration, blood loss and intraoperative complications, and after procedure were hospital stay, medical expenses and histopathology report. Urinary incontinence was assessed at 3 months follow-up. Mean age distribution was comparable(p value = 0.95). No significant difference was seen in preoperative PSA (p value = 0.326), MRI reports (p-value = 1) and transrectal biopsy (p-value = 0.789). None of the patients suffered from any major intraoperative complications. No significant difference was seen in blood loss (p value = 0.903). However there was significant difference was seen in mean duration of surgery(Hugo RAS vs Da Vinci ; 329.92 ± 66.45 vs 226.67 ± 35.31; p value < .0001). No significant difference was seen in discharge(p value = 0.552) and medical expenses(p value = 0.051). The histopathological examination results and margin status were comparable in both groups(p value = 1). No significant difference was seen in urinary incontinence at 3 months follow up between the two groups. This study proves the safety and feasibility of RARP with the Hugo RAS system when compared to da Vinci Si system however long term outcomes in larger series need to be assessed.