Comparative outcomes of Hugo RAS and Versius surgical systems versus da Vinci in four urological procedures: a systematic review.

In 30 seconds

This PRISMA-guided systematic review compared Hugo RAS and Versius with da Vinci in robot-assisted radical prostatectomy, partial nephrectomy, pyeloplasty, and radical cystectomy. It included 19 non-randomised studies, comprising 21 procedural comparisons and 2,482 patients. Across the available evidence, peri-operative, oncological, and early functional outcomes showed no consistent differences between platforms in experienced, high-volume centres. Setup and docking times were consistently longer with the newer systems. The studies were not powered to establish equivalence, so the findings indicate no demonstrated difference rather than comparable effectiveness.

Key findings

• The review included 19 studies and 2,482 patients across 21 procedural comparisons.
• In radical prostatectomy, blood loss, length of stay, positive margin rates, and early continence outcomes overlapped, while setup and docking took longer with newer platforms.
• In partial nephrectomy, warm ischaemia times differed by five minutes or less, and trifecta rates were within 5 percentage points.
• The single small pyeloplasty study reported identical median operative times but provided minimal comparative information.

Why it matters

As newer robotic systems enter urological practice, comparative outcomes can inform evaluation of their performance against the established da Vinci platform. This review finds no consistent outcome differences in the available studies, but the evidence is too limited to establish equivalence. Distinguishing absence of demonstrated difference from proof of comparable effectiveness is important when interpreting early platform comparisons.

What to keep in mind

The included studies were small, non-randomised, and not powered to detect clinically meaningful differences or demonstrate equivalence; evidence was limited for some procedures.