Clinical Feasibility, Safety, and Quality-of-Life Outcomes of Robot-Assisted Total Hysterectomy Using the Hugo™ RAS System: A Prospective Observational Study

This prospective observational study evaluated the safety, learning curve, and postoperative quality-of-life (QOL) outcomes of robot-assisted total hysterectomy performed using the Hugo™ Robotic-Assisted Surgery (RAS) System at a single academic center. Forty-five consecutive patients underwent simple or radical hysterectomy by a certified gynecologic robotic surgeon. Operative metrics, perioperative outcomes, and patient-reported QOL were assessed using validated questionnaires, including the SF-8, Female Sexual Function Index (FSFI), Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), and International Prostate Symptom Score (IPSS), administered preoperatively and at 1 and 3 months postoperatively. Learning curve analysis was conducted using the cumulative sum (CUSUM) method.All procedures were completed without conversion to laparotomy or laparoscopy. Mean total operative time was 141.6 ± 30.7 minutes, mean console time was 105.6 ± 30.4 minutes, and mean blood loss was 23.6 ± 70.1 mL. Minor postoperative complications occurred in 13.3% of patients, all classified as Clavien–Dindo grade I–II and managed conservatively. The CUSUM curve demonstrated that operative proficiency was achieved after approximately 15–20 cases. QOL outcomes showed transient postoperative fluctuations but overall preservation of general health, urinary function, and sexual function, with SF-8 physical and mental component scores returning to baseline by 3 months.In conclusion, robot-assisted hysterectomy performed with the Hugo™ RAS System was safe, efficient, and associated with a short learning curve. Postoperative QOL was well maintained, supporting the feasibility and patient-centered value of this emerging robotic platform.