A systematic review and meta-analysis of prospective studies comparing perioperative outcomes between the MP1000 and Da Vinci surgical systems for robot-assisted partial nephrectomy

Renal cell carcinoma is a common malignancy of the urinary tract, and surgery has long been the main therapeutic strategy. With greater understanding of cancer biology and renal physiology, nephron-sparing surgery has emerged as the standard of care for very early-stage renal cancer. Robotic-assisted partial nephrectomies are currently commonplace due to their advantageous post-surgical recovery profile, but the expense associated with conventional robots is a barrier to their availability. In recent years, new robotic systems such as the domestically developed MP1000 have been introduced into clinical practice, though their efficacy and safety require systematic evaluation. The purpose of the present study is to evaluate and compare the postoperative and intraoperative effects of the MP1000 and the Da Vinci Surgical System on patients with early-stage renal cancer who have undergone partial nephrectomy. Extensive literature searches were conducted on EMBASE, Scopus, PubMed, and the Web of Science databases to identify clinical trials on comparisons between MP1000 robot-assisted partial nephrectomy and Da Vinci partial nephrectomy. The variables under evaluation were the following: time of surgery, total rate of complications, intraoperative blood loss, warm ischemia time, docking time, console time, blood levels of eGFR at 2 days and 4 weeks after surgery, and rate of positive margins. In the case of categorical variables, the Odds Ratio, and in the case of continuous variables, the mean difference was used, and 95% confidence interval. Four studies involving 405 participants were used. No significant differences were found regarding the operation time, total rate of complications, intraoperative blood loss, warm ischemia time, levels of eGFR at 2 days and 4 weeks postoperatively, and rate of positive resection margins. Compared to the DaVinci group, docking time (WMD = 1.60 min, 95% CI: 1.3 to 1.9, p < 0.05) and console time (WMD = 23.1 min, 95% CI: 8.43 to 37.77, p < 0.05), were significantly longer for the MP1000 group. Under the skilled control of robot surgeons, the MP1000 Surgical System is equivalent to the Da Vinci Surgical System regarding the operation time, amount of EBL, incidence of post-operative complications, and eGFR levels during the first post-operative week. Although the MP1000 currently requires longer docking and console times, this gap is expected to narrow with accumulated surgical team experience. Overall, MP1000 in several perioperative indicators showed initial comparability. However, these findings are preliminary and exploratory. Further research is needed to establish the MP1000 platform with greater certainty for partial nephrectomy and other urological procedures.