placeUnited Kingdom
Contact & Support

Modular Design in Surgical Robotic Systems

Learn what inspired the modular design of the Hugo™ Robotic-Assisted Surgery (RAS) system.

by Kevin Fogarty, Medical Education Program Manager and Emily Ludwig, Senior Clinical Systems Engineer

From the earliest days, the primary goals for the Hugo™ Robotic-Assisted Surgery (RAS) system were to expand access to robotic-assisted surgery and help hospitals increase their RAS capacity. To do that, our design team knew that we had to disrupt the status quo by optimizing efficiency and increasing flexibility with our system.

Working closely with surgeons from around the world in the design process, we decided to take a new approach and make the entire system modular. This configuration, including mounting the arms on separate carts, was central to meeting our core goals and transforming how surgeons use RAS.

Flexibility for each patient and robotic-assisted surgical procedure

The modular design of the Hugo™ RAS system allows the surgeon to position the arms in various ways, relative to one another, based on the patient’s specific needs, the type of procedure, the disease state, whether it’s a simple or complex case, and their preferred technique.

"The modular structure of Hugo™ RAS system provides more flexibility and a greater docking angle range for different procedures."1

- Mintz Y, et al.

Our system documentation includes Medtronic-endorsed setup guides based on extensive surgeon input. Since the modular design is flexible, it can also support surgeon preference in the setup. This way, they can choose optimal locations, which may allow procedural efficiency and increased range of motion for better access to anatomy.

Freedom of tilt

Using four modular arm carts, as opposed to one tower or boom where all of the arms have to come down from above the patient, gives surgeons a significant opportunity for different degrees of freedom in the tilt angles of the arms. That’s a variable that can’t be controlled in many other mounting designs.

The modular design also provides the opportunity to have arms coming from the top down, over the patient, and also working up from below, towards the patient. The flexibility of the modular design provides potential benefits such as:

  • Creating configurations that better accommodate OR space
  • Allowing for the setup to be specific to various disease states
  • Giving the surgeon more options in the techniques used

Hugo RAS System tilt animation

Multi-quadrant access

Since the Hugo™ RAS system arms do not come from one fixed location, they can span out around the patient, giving the surgeon the ability to essentially rotate the arms up towards the upper quadrant’s gastric structures. Then, in the same procedure, the surgeon can navigate down into the pelvic region. This allows true multi-quadrant access.

Efficiency of OR use

Another factor we considered is that a modular design for the entire system makes it easier to move between operating rooms. The individual arm carts are portable, so they can be moved easily between rooms without being powered on, just like the majority of other OR equipment. Modular arms can be stowed when not in use allowing the OR to be used for non-RAS cases.

Use only the arms you need

Some procedures, such as hernia repairs, don’t typically require four arms. Modular arm carts give the surgeon the flexibility only to use three. This can help optimize OR space, save time in setup and lower the cost of disposables such as sterile drapes.

Using fewer arms in specific procedures may also allow the hospital to maximize the efficiency of its robotic fleet, acquiring multiple 3-arm systems, especially for use on high-volume procedures such as hernia repair.

Robotic-assisted hernia surgery

For ventral hernia, the standard recommended setup has three arms coming from one side, which allows optimum ventral reach for instruments. This differs from some procedures where symmetric arm setups are often recommended.

Robotic-assisted prostatectomy

The modular design can benefit how a surgeon approaches prostatectomy, which is one of the most common robotic procedures today. In our discussions, many physicians expressed different preferences in terms of setup for this procedure. For example, many surgeons prefer to keep the patient’s legs straight throughout the procedure, positioning the endoscope arm off to the side – the modular design gives that flexibility.

When an unexpected situation due to a patient’s anatomy or disease state occurs, the modular design allows surgeons to adjust and address it in real-time. Feedback has shown that some surgeons have modified their setups to fit their technique, OR size, and other factors. Modularity gives them the flexibility to do what’s right for each patient.

"The ability to individually customize the configuration of trocars and arm carts proved instrumental in providing an expanded working space and preventing inadvertent system failures due to instrument clashes."2

– Prata, et al.

The entire OR team matters

Surgeons and their teams have the flexibility to adjust the modular arm cart positions to optimize space for the assistant and other staff. In addition, the modular system tower with the OR team interactive display can be configured so that the bedside assistant has optimal visibility.

An entirely modular design means Hugo™ RAS system puts choice in the hands of surgeons and their teams to provide the best possible care for each and every patient.

  1. Mintz Y, et al. Robotic inguinal hernia repair with the new Hugo RAS™ system: first worldwide case series report.
  2. Prata F, Ragusa A, Civitella A et al. Robot-assisted partial nephrectomy using the novel Hugo™ RAS system: Feasibility, setting and perioperative outcomes of the first off-clamp series. Urologia 2024:3915603231220109. https://doi.org/10.1177/03915603231220109.

The Medtronic Hugo™ RAS system is commercially available in certain geographies. Regulatory requirements of individual countries and regions will determine approval, clearance, or market availability. In the EU, the Hugo™ RAS system is CE marked. In the U.S., the Hugo™ system is an investigational device not for sale. Touch Surgery™ Ecosystem is not intended to direct surgery, or aid in diagnosis or treatment of a disease or condition.