Extraperitoneal robot-assisted radical prostatectomy by the da Vinci and Versius System: first comparative analysis.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic-assisted surgery has transformed urology.
• The Versius Surgical System offers a new alternative to the established da Vinci system.
• This study compares outcomes of extraperitoneal robot-assisted radical prostatectomy (eRARP) between these two platforms.

Purpose of the Study:

• To compare the clinical outcomes of eRARP using the da Vinci and Versius robotic systems.
• To present the largest case series to date comparing these two robotic platforms for eRARP.

Main Methods:

• Retrospective analysis of 106 consecutive patients undergoing eRARP.
• Comparison between da Vinci and Versius systems from July 2021 to July 2023.
• Analysis of baseline characteristics, perioperative outcomes, and pathology results by a single surgeon.

Main Results:

• Comparable baseline characteristics, operative time, blood loss, and hospital stay between the two systems.
• Variations observed in pelvic lymphadenectomy rates and nerve-sparing procedures.
• No significant differences in ISUP grades or positive surgical margins, but a higher percentage of positive lymph nodes (Pathological N stage) with Versius.

Conclusions:

• This study represents the largest comparative case series of da Vinci vs. Versius for eRARP.
• Overall surgical outcomes are similar, but differences in lymphadenectomy and Pathological N stage require attention.
• Further research and long-term follow-up are needed to guide optimal robotic system selection in urological surgery.