Evaluation of the New Robotic Platform "HINOTORI™" in Urologic Robot-Assisted Surgery: From a Comparison with da Vinci<sup>®</sup> Surgical System in Sacrocolpopexy.

Abstract

<b>Background/Objectives:</b> HINOTORI™ is a robotic-assisted surgical platform developed in Japan. It has been applied in urologic procedures such as robot-assisted radical prostatectomy (RARP) and partial nephrectomy (RAPN). This study aimed to evaluate the clinical performance of HINOTORI™ compared with the da Vinci^® surgical system by analyzing outcomes of robot-assisted sacrocolpopexy (RSC) performed by a single skilled surgeon using a uniform surgical procedure. <b>Methods:</b> A total of 125 patients who underwent RSC for pelvic organ prolapse (POP) were analyzed. Surgical outcomes were compared between the HINOTORI™ (h-RSC group) and da Vinci^® (d-RSC group) platforms. Evaluated parameters included operative time, robotic console time, anterior compartment dissection time, suture time per stitch, perioperative complications, hospital stay, and POP recurrence. <b>Results:</b> Operative and robotic console times were significantly longer in the h-RSC group (148 vs. 139 min, <i>p</i> < 0.005; 109 vs. 95 min, <i>p</i> < 0.001). Anterior compartment dissection time showed no significant difference (<i>p</i> = 0.58), but suture time per stitch was longer in the h-RSC group (76 vs. 60 s, <i>p</i> < 0.005), possibly due to limited suture-cutting functionality, requiring manual assistance. No significant differences were observed in perioperative complications, hospital stay, and POP recurrence. <b>Conclusions:</b> HINOTORI™ demonstrated surgical precision and safety comparable to the da Vinci^® surgical system. It may serve as a viable alternative robotic platform, supporting broader adoption of robot-assisted surgical technologies.