Robotic Left Minor Liver Resection With the Hugo™ RAS System: Initial Experience

Abstract

Introduction

Minimally invasive liver resection has become an established approach in selected patients, offering reduced blood loss, lower morbidity, and faster recovery compared with open surgery. The recent introduction of new robotic systems, such as the Hugo™ RAS (Medtronic), has expanded the potential of robotic hepatobiliary surgery. This study reports the first clinical experience with robotic liver resection (RLR) performed using the Hugo™.

Methods

A prospective case series was conducted at a tertiary referral centre, including the first 3 consecutive patients who underwent robotic liver resection for colorectal liver metastases (CRLM) between April and June 2025. Demographic, perioperative, and oncological data were collected and analyzed descriptively. All procedures were performed by experienced hepatobiliary surgeons using the Hugo™ RAS platform.

Results

Three patients (2 males; median age 84 years) underwent minor hepatectomies: 2 left lateral sectionectomies (segments II–III) and one combined non-anatomical resection of segments II–III–IVb with cholecystectomy. All operations were completed robotically without conversion. The median operative time was 210 minutes (range 180-240), median docking time was 15 minutes, and median blood loss was 50 mL (range 50-100). No intraoperative complications occurred. Median hospital stay was 4 days (range 3-5). No postoperative complications or readmissions were recorded at 30- and 90-day follow-up. All specimens achieved R0 margins.

Conclusions

RLR using the Hugo™ RAS system is feasible and safe in selected minor hepatectomies.