Early Clinical Outcomes of the Novel Hinotori Robotic System in Urological Surgery

Introduction: The advances in urological surgery across the decade has continued to burgeon, particularly in the pursuit of minimally invasive approaches for major operations. Robotic-assisted surgery has gradually established its role in uro-oncological cases that demand a high level of precision, optimising surgeon ergonomics and decreasing fatigue whilst maintaining optimal clinical outcomes. With the novel Hinotori surgical robot (Medicaroid Corporation (Kobe, Hyogo, Japan) launched in Japan back in 2019, it has now demonstrated its use case across various clinical series of different surgeries. We sought to narratively synthesise the initial feasibility of the Hinotori robotic system in Urology. Methods and Results: A non-systematic, comprehensive literature search was conducted across various databases from September 2024 to October 2024. Relevant keywords within the scope of this study were generated for a more accurate search. After exclusion and removal of duplicates, a total of nine articles that encompassed a diverse range of urological surgeries were included for review. Among the included studies, one study reported data solely on radical prostatectomy for prostate cancer, two studies reported on robotic-assisted nephroureterectomy for renal tumors, two studies on partial nephrectomy performed for renal masses, two studies reported on radical nephrectomy carried out for renal malignancies and one study on robotic-assisted adrenalectomy for adrenal cancer. Lastly, one study collectively reported on outcomes pertaining to partial nephrectomy, partial nephrectomy, vesicourethral anastomosis and pelvic lymph node dissection in porcine, as well as partial nephrectomy, radical prostatectomy and pelvic lymph node dissection in cadavers. Conclusion: The new Hinotori robotic system offers unique three-dimensional features as a non-inferior robotic platform alternative that has proven clinically safe thus far in its use. Larger scale studies and randomised trials are eagerly awaited to assess and validate more holistically its clinical utility.