Hinotori vs. da Vinci: Japan’s Robot Enters Europe
Hinotori is Japan's first surgical robot to challenge the da Vinci system.
Medicaroid, a joint venture of Kawasaki Heavy Industries and Sysmex, developed it, and Japanese operating rooms have used it since 2020.
In 2026, it also earned the CE mark under the EU Medical Device Regulation, which opens European hospitals to a robot that has so far been used mainly in Asia.
How Hinotori Differs From da Vinci
Hinotori has the same three-unit layout as da Vinci: a surgeon cockpit, an operation unit, and a monitor cart.
Three design choices set it apart.
The eight-axis arms are meant to reduce collisions between arms outside the body.
Because the software sets the pivot point, the area around the port stays clear for the assistant.
What the Clinical Evidence Shows
The strongest early data come from urology, where Hinotori is most used.
In a first-in-human study of 30 prostatectomies across four Japanese hospitals, all procedures were completed.
Median robot time was 165 minutes, and four patients had recoverable errors.
The authors judged these results comparable to the first 30 da Vinci prostatectomies reported in 2002.
That comparison is to a 20-year-old learning curve, so it shows feasibility more than superiority.
A matched comparison of partial nephrectomies looked at 37 Hinotori cases and 74 da Vinci Xi cases.
It found no significant differences in major perioperative outcomes.
Through 2023, 2,314 urologic cancer patients had been treated with Hinotori, including 1,893 prostatectomies.
The authors are urologists at Kobe University, where the first Hinotori operation took place, and the data come largely from that institution.
They state that long-term cancer outcomes and quality of life still need to be compared between the two platforms.
Where Hinotori Still Falls Short
The same review names two problems.
The instrument lineup is too limited for some operations, which likely explains why only 16 bladder removals had been done by 2023.
The system also has no on-screen annotation function, which weakens how well an experienced operator can mentor a trainee during a case.
The review dates from 2024, so the instrument library may have grown since then.
The authors list remote surgery, robotic autonomy and AI analysis of procedures as projects in progress, which means Hinotori is a fully surgeon-controlled system today.
Why the CE Mark Matters
Medicaroid announced CE marking under the EU Medical Device Regulation on July 9, 2026.
The mark lets the company market Hinotori in EU member states and certain non-EU countries, and it does not apply to the United States.
Before Europe, the system had won approval in Japan in 2020, Singapore in 2023, Malaysia in 2024, and Vietnam in 2026.
Medicaroid Europe GmbH has operated from Germany since 2020 as the company’s base for Europe, the Middle East and Africa.
TÜV SÜD, the certifying body, issued the EU certificate and held a certification ceremony with Medicaroid on September 15, 2026.
For European hospitals, the practical question is no longer whether a second platform exists, but whether Hinotori’s instrument range and training support will match da Vinci’s.
A wider look at robotic platforms and their evidence appears in The 2026 Surgical Technology Intelligence Report.
