Study Compares Three Robotic Systems for Colon Cancer Surgery, Finding Feasibility but Differences in Performance
A prospective study comparing Da Vinci Xi, Hugo™ RAS, and Versius® robotic platforms for colon cancer surgery found all were feasible but revealed differences in conversion rates, operating time, and instrument usage, highlighting the need for larger trials.
A new study published in Laparoscopic, Endoscopic and Robotic Surgery provides the first prospective comparison of three robotic surgical platforms—Da Vinci Xi, Hugo™ RAS, and Versius®—in colon cancer surgery. The findings, published in the journal and available at DOI:10.1016/j.lers.2025.10.001, indicate that while all systems are feasible when used by experienced surgeons, there are notable differences in performance metrics that could influence surgical decisions.
The COMPAR-CRC study enrolled 45 consecutive adult patients undergoing robotic colon resection between February and December 2024 across two surgical units. Two experienced colorectal surgeons performed all procedures, with each robotic platform—Da Vinci Xi, Hugo™ RAS, and Versius®—used in 15 cases. The mean patient age was 66.8 years, and 68.9% of surgeries were for colon cancer. The primary outcomes focused on conversion to laparoscopy or open surgery and intra-operative complications, while secondary outcomes included post-operative recovery, oncological results, and platform-specific technical parameters.
Results showed no conversions in the Da Vinci group, whereas two conversions to laparoscopy occurred with Hugo™ RAS and three with Versius®. One intra-operative instrument malfunction was reported with Hugo™ RAS, and one surgical complication occurred in each group. No significant differences were observed in post-operative recovery or oncological outcomes. However, Versius® cases required more frequent use of laparoscopic energy devices (p < 0.001), and Hugo™ RAS was associated with longer total operating room time (p = 0.022) and longer incision length (p = 0.005).
The study's authors, noting that Da Vinci has long been the dominant robotic system, emphasize that these newer CE-marked platforms—Hugo™ RAS and Versius®—are now available in Europe and offer alternatives. The findings suggest that expert surgeons can achieve comparable results across platforms, but the differences in conversion rates and technical parameters warrant further investigation. "While early outcomes are encouraging, larger comparative trials are needed to confirm differences in recovery and oncological efficacy," the authors wrote.
The implications for hospitals and surgeons considering investment in robotic systems are significant. The Da Vinci system, with its established track record, showed the lowest conversion rate, while Hugo™ RAS and Versius® presented trade-offs in operating time and instrument usage. As the field of robotic surgery evolves, these data provide early evidence to guide platform selection, though the small sample size limits generalizability. The study was published in Laparoscopic, Endoscopic and Robotic Surgery, a journal focused on advancing minimally invasive techniques across multiple specialties, including colorectal surgery.