Abstract
Background
Independent-arm robotic systems offer flexible instrument assignment, but standardized colorectal workflows are limited. We developed the HUGO-SWAP workflow, a single-docking strategy enabling phase-specific instrument reassignment, and evaluated its clinical feasibility.
Methods
From April 2020 to December 2025, 298 patients underwent robotic colorectal resection. After exclusions, 274 patients were analyzed. Propensity score matching (1:2) was performed to provide a comparative reference using the da Vinci Xi system. Postoperative complications were the primary outcome.
Results
After matching, 41 HUGO and 82 da Vinci cases were analyzed. Postoperative complication rates were comparable (19.5% vs 22.0%). Oncologic outcomes, including lymph node yield, pathological stage, and margin status, were similar. Operative time was longer in the HUGO group (254 vs 216 min), while no cases required re-docking or conversion.
Conclusions
The HUGO-SWAP workflow enables safe implementation of single-docking robotic colorectal surgery on an independent-arm platform, with preserved short-term safety and oncologic adequacy. These findings support the feasibility and reproducibility of this workflow in clinical practice.
Keywords
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