Comparative evaluation of robotic surgical systems in oculoplastic surgery: A study of Da Vinci versus medtronic hugo RAS in standardized eyelid incisions

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BACKGROUND: Theoretically, robotic surgical platforms offer advantages in precision, tremor elimination, and certain degree of visualization for periocular surgeries. However, there are no published studies where a direct comparative assessment of two independent robotic systems has been performed for the creation of common eyelid incisions. We report, to our knowledge, the first head-to-head comparison of the Medtronic Hugo RAS® and Intuitive da Vinci® surgical systems for this purpose. METHODS: Six standard periocular incisions were first decided and then performed using both platforms on fresh goat eyelid specimens. A single oculoplastic surgeon, who had also received training in robotic surgical systems, performed the procedures and then rated each incision. The parameters included time to completion, ease of execution, size control, and shape control. A composite quality score was derived. Statistical comparison was performed using the Wilcoxon signed-rank test. RESULTS: All six incision types were successfully executed on both platforms. Hugo RAS® and Da Vinci® achieved nearly identical quality scores across all six incisions (composite mean 9.00 ± 2.00 for both; P = 1.00). The durations for incision created were marginally shorter with the Da Vinci (mean 28.5 ± 18.7 seconds vs. 32.0 ± 21.4 seconds; mean difference 3.5 seconds; P = 0.06). Hair-bearing sites required 3.4-3.7 times longer than hairless-region incisions on both platforms. CONCLUSION: Both platforms demonstrated equivalent technical capability and quality for all six standard eyelid incisions. The Da Vinci® system showed a nonsignificant trend toward faster execution.

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