Robotic-assisted sacrocolpopexy with hinotori, a brand-new surgical robot system produced in Japan; report of initial clinical case series

Introduction and Hypothesis: Robot-assisted sacrocolpopexy (RASC) is increasingly common due to the increased uptake of surgical robot systems. The aim of this retrospective study was to assess the perioperative outcomes of the first patient cohort to undergo RASC using a brand-new surgical robot system, the hinotori surgical system (robot-assisted sacrocolpopexy with hinotori surgical system [h-RASC]). This study also aimed to compare the outcomes of this group with those of the group of patients who had undergone RASC with the da Vinci surgical system (d-RASC). Methods: This study included 15 patients per group. Operative times, blood loss, complications, overactive bladder symptom score (OABSS; subjective measure), and urodynamic outcomes (objective measure) were compared between the groups. Results: All cases were completed without serious problems during RASC procedure. Perioperative outcomes were similar between the groups except for longer operation time (min) (h-RASC 266 vs. d-RASC 229; p < .01) and console time (min) (178 vs. 159; p = .02) in the h-RASC group than in the d-RASC. De novo stress urinary incontinence (SUI) and pelvic organ prolapse (POP) recurrence were comparable. LUTS improved in the postoperative OABSS total score (preoperative 6 vs. postoperative 3; p < .01) in the h-RASC group. However, OABSS assessment (h-RASC -3 vs. d-RASC -4; p = .38) was similar between the two groups. Urodynamic studies showed similar outcomes in the median Qmax (maximum flow rate) values in both groups. Conclusion: This is the first report focusing on RASC using the hinotori surgical system. RASC using the hinotori surgical system could provide favorable perioperative outcomes as comparable with those of the existing da Vinci system.