A single case shows the Hugo RAS can complete abdominoperineal resection through the planned stoma site without arm interference—a technical proof of concept, not evidence of better outcomes.

• Three robotic ports were placed through the left lower-quadrant stoma site, with one additional right-sided port; console time was 167 minutes.
• The mesorectal specimen was complete, with 3-mm circumferential and 35-mm distal margins and 25 nodes harvested; recovery was uncomplicated apart from transient cystitis.

Reduced pain, better cosmesis, and fewer wound complications or hernias remain unproven; reproducibility needs further study.