Robotic surgery continues to evolve rapidly within gynaecology, with increasing platform diversity providing surgeons with more options than ever before. In Australia, we now have five TGA-approved robotic platforms available, and the conversation is shifting from simply “should I use a robot?” to “which robotic platform best suits my practice, my patients and my surgical style?”<\/p>\n
My own robotic journey, like many surgeons across Australia, began on the da Vinci platform. It revolutionised surgery for me, simplifying complex procedures, and was a technology I was immediately drawn to and incorporated into my practice. Like many gynaecological surgeons, however, I avoided the robotic vessel sealer simply because of cost considerations, a reality that reflects the broader funding disparities that continue to exist within women’s health and gynaecological surgery. This was a small compromise, as the advantages of robotic surgery, including vision, ergonomics, articulation and the additional arm, quickly changed how I performed surgery. I did not necessarily miss the laparoscopic LigaSure I had relied on heavily during my laparoscopic cases.<\/p>\n
When I later trained on the Hugo RAS System platform, robotic LigaSure was not initially available. Again, this was not a major issue. The robot still offered the core advantages that had drawn me to robotic surgery. But when LigaSure became available on Hugo, I was curious.<\/p>\n
My first reaction was not enthusiasm.<\/p>\n
The instrument felt limiting. It did not articulate. The jaw was Maryland-style rather than the blunt tip LigaSure I personally prefer. I could not partially compress the trigger to cautiously “test the waters” before committing to a seal and divide. It felt more binary, more “all or nothing”. In deep pelvic spaces, particularly where angulation matters, the lack of articulation remains a genuine limitation.<\/p>\n
But then came the realisation.<\/p>\n
This was not trying to behave like a fully wristed robotic instrument. Instead, it felt like a laparoscopic LigaSure brought into the robotic environment. It was even 5 mm and looked strikingly familiar. That familiarity became its strength.<\/p>\n
For a surgeon who has used LigaSure for years, the device felt like a familiar friend on foreign technology. It allowed seal and divide in one instrument, fewer instrument movements, smoother pedicle progression and efficient dissection through structures such as the fallopian tube, broad ligament and vascular pedicles. Importantly, this occurred while still benefiting from the strengths of the robot itself: stable vision, improved ergonomics, controlled traction and additional robotic arms to present tissue exactly where it was needed.<\/p>\n
This experience prompted us to review our early outcomes. At Hurstville Private Hospital in Sydney, two surgeons working with a consistent theatre team reviewed 34 robotic hysterectomies performed between 2023 and 2025. The LigaSure group was compared with a control cohort without LigaSure, with no statistically significant demographic differences between groups in age, BMI or uterine size.<\/p>\n
While small, the study demonstrated an approximately 8.5 minute reduction in operative time in the LigaSure group (50.4 minutes vs 58.9 minutes, p=0.05), without an increase in complications. Although not designed to prove superiority, it suggested there may be genuine efficiency advantages in selected robotic hysterectomy cases.<\/p>\n
It is not perfect. I still prefer other instruments for fine dissection, severe endometriosis, ureteric mobilisation, retroperitoneal dissection and precise colpotomy edge creation. Arm positioning matters, and tissue often needs to be deliberately presented to the robotic LigaSure using the other robotic instruments.<\/p>\n
But despite its limitations, I do believe robotic LigaSure has a place in my surgical armamentarium. Not because it replaces articulation, but because it combines something familiar with something new. For laparoscopic surgeons entering robotics, that familiarity may help reduce the cognitive load and barriers associated with adopting robotic technologies.<\/p>\n
Dr Dean Conrad<\/p>\n\n","protected":false},"excerpt":{"rendered":"
Explore a surgeon\u2019s firsthand review of the Hugo RAS robotic LigaSure, weighing its physical limitations against the clinical advantages it brings to the theatre.<\/p>\n","protected":false},"author":11,"featured_media":72,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-160","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorised"],"acf":[],"_links":{"self":[{"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/posts\/160","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/comments?post=160"}],"version-history":[{"count":5,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/posts\/160\/revisions"}],"predecessor-version":[{"id":231,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/posts\/160\/revisions\/231"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/media\/72"}],"wp:attachment":[{"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/media?parent=160"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/categories?post=160"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/escope.ages.com.au\/july-2026\/wp-json\/wp\/v2\/tags?post=160"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}