Emerging Robotic Platforms in Radical Prostatectomy: A Comparative Systematic Review and Network Meta-Analysis

Area of Science:

• Urology
• Surgical Technology
• Medical Robotics

Background:

• Robotic platforms are increasingly used in clinical practice.
• Direct comparisons of perioperative outcomes for robot-assisted radical prostatectomy (RARP) across different platforms are limited.

Purpose of the Study:

• To conduct a systematic review and network meta-analysis of RARP outcomes across various robotic platforms.
• To compare operative time (OT), estimated blood loss (EBL), and length of stay (LOS) between different RARP systems.

Main Methods:

• Systematic search of PubMed, CINAHL, Scopus, and Cochrane for relevant cohort studies and RCTs.
• Inclusion of 18 studies with 3511 patients undergoing RARP for localized prostate cancer.
• Network meta-analysis focusing on OT, EBL, and LOS across 9 robotic platforms.

Main Results:

• No significant differences in LOS or EBL were found across the robotic platforms.
• Da Vinci Multiport (MP) platforms showed longer OT compared to Shurui Single-Port (SP), KangDuo, Revo-i, and da Vinci SP.
• The Senhance platform demonstrated a shorter OT compared to da Vinci MP platforms.

Conclusions:

• This is the first network meta-analysis comparing perioperative outcomes of RARP across emerging robotic platforms.
• Findings indicate no clinically significant differences in LOS and EBL.
• Significant variations in OT suggest the impact of novel robotic technologies on surgical efficiency.