An observational series of 118 patients with colorectal cancer reported no intraoperative complications and no conversions to open surgery during Hugo-assisted operations. The group included 57 patients with colon cancer and 61 with rectal cancer.
The study focused on perioperative and short-term outcomes, meaning events recorded around surgery and soon afterward. It was not designed to determine whether Hugo performs better than another surgical approach, because no randomized allocation or comparison group was reported.
The results in detail
Operating times were reported as medians, meaning the midpoint when cases are arranged from the shortest operation to the longest. The median was 281 minutes for colon cancer and 328 minutes for rectal cancer.
The report also gave complications as event counts. On the Clavien-Dindo complication scale, Grade II complications occurred in three colon cancer patients and six rectal cancer patients. Grade III complications occurred in two patients in the colon group and one in the rectal group.
The absence of a conversion to open surgery should not be read as an absence of complications overall. The report's complication counts and its conversion result describe different parts of the perioperative experience.
The supplied analysis presents the findings descriptively, using medians for operative time and counts for complications. It does not report inferential tests or uncertainty estimates for these results.
A narrow test of the system
The patients were consecutive cases treated at one center, and the researchers reviewed the observational record retrospectively. In practical terms, the study looked back at care that had already occurred rather than assigning patients to Hugo or another method. No randomized allocation or comparison or control group was described.
That design can show what happened among the reported patients, but it cannot establish that Hugo caused the observed outcomes or that it is better, worse, or equivalent to another method. The findings describe this team's experience rather than settle the system's comparative performance.
All procedures were performed by or under the supervision of a surgeon with substantial experience in robot-assisted colorectal surgery. Results from that setting may not carry over unchanged to teams with different levels of robotic experience.
The authors' conclusion
The authors interpret the series as evidence that Hugo-assisted surgery is feasible and safe. They also describe it as the largest single-center series reported to date and say the results support the system's applicability.
The paper's title says it includes a literature review as well as the initial case series, but the review's methods and findings were not provided in the material reviewed here. The basis for the largest-series description therefore cannot be assessed from the supplied information.
What the report does not answer
The study's stated focus was perioperative and short-term outcomes. It does not provide long-term oncologic or patient-centered outcome estimates, so the reported results do not answer questions about longer-term cancer outcomes or patient experience.
Publication and disclosures
The paper is identified as a peer-reviewed Original Article and was published on 21 August 2026. Funding is not reported in the supplied text, while the acknowledgements thank Editage for English-language editing.
The reported conflict of interest is that KO received lecture fees from Medtronic outside the submitted work.
Paper data and sources
Original title: Robot-assisted surgery for colorectal cancer using the Hugo™ RAS system: an observational study with the initial 118 cases and a literature review.
Authors: Takehito Yamamoto, Yoshiro Itatani, Koya Hida et al.
Journal/Repository: Surgery today
Status: Peer-reviewed
First online: 2026-08-21
DOI: 10.1007/s00595-026-03449-z
Original paper · Full text