Application Effect of Different Robotic Surgery Systems in Radical Prostatectomy: A Comparative Study Based on a...

Area of Science:

• Urology
• Surgical Technology
• Oncology

Background:

• Prostate cancer (PCa) presents significant global health challenges with increasing incidence and mortality.
• Robot-assisted radical prostatectomy (RP) is a preferred minimally invasive surgical approach for PCa.
• Evaluating different robotic surgical systems is crucial for optimizing patient outcomes.

Purpose of the Study:

• To conduct a network meta-analysis (NMA) comparing four robotic surgical systems: Da Vinci (DV), KangDuo (KD), Hugo (HG), and Hinotori.
• To assess the clinical performance of these systems in RP for PCa.
• To provide evidence-based insights for selecting robotic systems based on clinical priorities.

Main Methods:

• Systematic review and NMA following PRISMA guidelines, including studies up to January 2025.
• Inclusion of randomized controlled trials and observational studies comparing the four robotic systems in RP for PCa.
• Analysis of outcomes including operative time, blood loss, hospital stay, complications, urinary incontinence, and surgical margins.

Main Results:

• Data from 2064 patients across 15 studies were analyzed.
• Da Vinci (DV) demonstrated the shortest operative time (SUCRA: 90.7).
• No significant differences were observed in blood loss, hospital stay, or complication rates, though KD showed a slight advantage in hospital stay (SUCRA: 85.8) and HG had the lowest complication rate (SUCRA: 84.3).
• Positive surgical margins and 3-month urinary incontinence rates were comparable across all systems.

Conclusions:

• All evaluated robotic systems offer comparable safety profiles for radical prostatectomy in prostate cancer patients.
• Da Vinci excels in operative efficiency, while KangDuo shows potential benefits in postoperative recovery and blood loss control.
• System selection can be tailored to specific clinical priorities, with ongoing research needed for personalized treatment strategies.