Medtronic’s Hugo Surgical Robot Achieves Breakthrough

In a major milestone for surgical robotics, Medtronic has announced that its Hugo™ Robotic-Assisted Surgery (RAS) system has successfully met all primary endpoints in a large-scale U.S. clinical trial for urologic procedures, paving the way for an anticipated FDA approval in late 2025. The results mark the most significant progress for a competitor to Intuitive Surgical’s da Vinci system in nearly two decades.

The clinical study, called EXPAND URO, was presented at the 2025 American Urological Association (AUA) Annual Meeting, showcasing pivotal trial results for Hugo in prostatectomy, nephrectomy, and cystectomy. It involved 139 patients across six U.S. academic hospitals, treated by 11 leading urologists.

Key Metrics:

• Success Rate: 98.5%, surpassing the 85% benchmark (p < 0.0001)

• Safety Outcomes: Low complication rates — 3.7% for prostatectomies, 1.9% for nephrectomies, and 17.9% for cystectomies, all within or below national averages

• FDA Submission Status: Finalized trial data submitted as part of Medtronic’s premarket review package

According to Medtronic, these results validate Hugo’s safety, usability, and performance across multiple urologic specialties—a crucial step as it seeks full U.S. commercial clearance.

Why It Matters for Surgical Stakeholders

This trial is more than just a clinical success—it signals a market shift. Since 2000, Intuitive Surgical's da Vinci has maintained an almost unchallenged hold over robotic surgical system. The entry of Hugo—already approved in several countries outside the U.S.—presents the first viable alternative for hospitals and surgery centers seeking choice, cost efficiency, and innovation.

Key Impacts:

• Cost competitiveness: Early adopters of Hugo in Latin America and Asia reported significant capital and per-procedure savings compared to da Vinci.

• New features: Hugo uses modular arm design with integrated video analytics and real-time OR data capture.

• Access expansion: With a second major platform available, smaller hospitals and high-volume ASCs may gain access to robotics previously out of reach due to capital constraints.

Hospitals & Surgical Centers

• Gain procurement leverage with multiple vendors, allowing strategic equipment planning and capital efficiency.

• May restructure robotic surgery programs to include multi-platform usage, optimizing for different procedures or specialties.

Surgeons & Clinical Leaders

• We should prepare for dual-platform training and credentialing pathways as Hugo becomes available.

• Hugo’s open console design and modularity may appeal to surgeons trained in both open and laparoscopic techniques.

Distributors & Device OEMs

• Opportunity to diversify portfolios with Hugo-compatible instruments, drapes, and sterilization trays.

• Expected to support onboarding, clinical training, and service contracts for early adopters.

Payers & Policymakers

• Faster recoveries and fewer complications from robotic urologic surgeries may influence reimbursement strategies and procedure authorization guidelines.

• CMS and private insurers are likely monitoring this closely to assess cost-benefit versus traditional laparoscopic or open techniques.

To capitalize on Hugo’s FDA trajectory, surgical and supply chain leaders should initiate the following steps:

Focus Area Suggested Actions

Capital Planning Model cost-of-ownership vs. existing robotics programs; include training and disposable costs

Clinical Readiness Coordinate urology, gynecology, and general surgery leads to pilot use-case exploration

Training Infrastructure Begin discussions with Medtronic on proctoring, certification, and staff education

Vendor Contracts Request parallel proposals from Medtronic and Intuitive for competitive benchmarking

Marketing & Recruitment Publicize new robotic offerings to attract high-skill surgeons and increase patient interest

Dr. Michael Abern, principal investigator of the EXPAND URO trial, shared:

“This study demonstrated that the Hugo RAS system is safe and effective for urologic procedures. These results mirror what we've seen from well-established systems—and in some metrics, even improve on them.”

Surgeons reported positive feedback on console ergonomics, camera control, and setup time—factors critical for adoption at scale.

While pricing is confidential, early international Hugo installations have shown:

• 20–30% lower capital acquisition costs

• Reduced annual maintenance fees

• Fewer disposable constraints, enabling instrument flexibility

For many hospital systems, these savings may enable expansion into robotic gynecology or colorectal surgery—areas previously underserved due to cost barriers.

The Hugo RAS system is poised to become the first real alternative to da Vinci in the U.S. robotic surgery market. Its FDA clearance—likely within 2025—will not only expand the provider choice but redefine how robotic surgery is priced, trained, and deployed nationwide. Hospitals and ASCs should act now to evaluate readiness and secure early adoption advantages.