Off-clamp robot assisted partial nephrectomy with Hugo RAS system for T2 renal mass

Partial nephrectomy is the gold standard for localized renal masses, offering oncological control while preserving renal function. The introduction of robotic platforms has extended the indications for partial nephrectomy to more complex cases, leveraging their precision and enhanced ergonomics. The Hugo™ RAS System is a modular robotic platform with independent arm carts, enabling patient-tailored surgical approaches. However, its application in nephron-sparing surgery remains limited.

We report the case of a 25-year-old male presenting with a 9.5 cm right renal mass (PADUA score: 11), who underwent robot-assisted partial nephrectomy using the Hugo™ RAS System. To optimize nephron preservation, an off-clamp approach was employed. The procedure was completed successfully without intraoperative complications or system malfunctions. Docking and console times were 3 and 96 minutes, respectively, and estimated blood loss was 350 mL. Postoperative renal function remained comparable to preoperative values. The patient had an uneventful recovery and was discharged on postoperative day 3.

This case highlights the safety and feasibility of the Hugo™ RAS System for complex, nephron-sparing surgery. The platform's modular design facilitates flexible docking and trocar placement, enabling a customized surgical strategy tailored to the patient's anatomy. In experienced hands, it demonstrates the capability to manage high-complexity renal tumors effectively and the potential of the Hugo™ RAS System as a versatile tool for challenging nephron-sparing surgeries.