# European Delphi consensus on specific training, implementation requirements, and clinical use for the Hugo™ robotic-assisted surgery platform in colorectal procedures

## TL;DR

Experts in Europe reached a consensus on training and guidelines for using the Hugo™ robotic system in colorectal surgery.

## Contribution

This is the first international expert consensus on the Hugo™ robotic-assisted surgery platform for colorectal procedures.

## Key findings

- 33 out of 78 statements achieved consensus agreement (>80%) as recommendations.
- 15 statements showed consensus disagreement (<20%), highlighting areas of uncertainty.
- The Delphi process involved 11 experts with a 100% response rate across three rounds.

## Abstract

A new robotic platform, the Hugo™ robotic-assisted surgery (RAS) system, has been introduced to the market, featuring innovations such as modular arms and an open console, distinguishing it from the Da Vinci system. These differences highlight the need to establish specific, standardized training, credentialing criteria, and clinical guidelines for the use of this platform. To date, this represents the first international expert consensus on the Hugo™ RAS system.

Eleven European colorectal experts with experience using the Hugo™ RAS platform were invited to participate in this Delphi study. Seventy-seven questions related to this robotic platform were grouped into six domains: (1) required knowledge, (2) technical skills, (3) nontechnical skills, (4) assessment of competency/proficiency during training, (5) credentialing and clinical outcome data, and (6) setups and surgical technique. A three-round Delphi process was conducted. Participants were asked to indicate their agreement or disagreement using a Likert scale (0–5) regarding the proposed themes. Consensus was reached, with a minimum agreement level of 0.80 (80%).

All the experts completed the three Delphi rounds, ensuring a 100% response rate throughout the process. Of the 78 statements evaluated, 33 (42%) achieved consensus agreement (> 80%) and were considered consensus recommendations, while 15 statements showed consensus disagreement (< 20%). The remaining items reflected areas of uncertainty.

The first consensus statement on robotic colorectal surgery with the Hugo™ RAS platform, developed by a European panel of experts, represents an important milestone and provides recommendations for colorectal surgeons considering the adoption of this new robotic platform.

The online version contains supplementary material available at 10.1007/s00384-026-05118-6.