Procedure‑specific impact of body mass index on robot‑derived intraoperative telemetry: a retrospective...

Robotic platforms automatically record intraoperative telemetry, but body mass index (BMI) effects on these micrometrics are unclear.

This study aimed to evaluate BMI-telemetry associations overall and by procedure, focusing on robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN).

A retrospective consecutive single-surgeon cohort of 100 robot-assisted urologic procedures performed between April 2, 2024 and December 22, 2025 was analyzed. BMI was calculated for all participants. The primary outcome was console time, while secondary outcomes included instrument active time and camera installation rate. The associations were evaluated using the Spearman correlation and prespecified procedure-stratified models (log-linear regression for time outcomes and negative binomial regression with log [console time] offset for rate outcomes).

The cohort included RARP (n = 43), RAPN (n = 36), and other procedures (n = 21). BMI and console time were available for 97 cases. BMI correlated with console time overall (r = 0.272; P = 0.007) and in RARP (r = 0.487; P = 0.001; n = 40), but not in RAPN (r = 0.09; P = 0.6; n = 36). In the adjusted RARP models (age and extended pelvic lymph node dissection), each 5 kg/m² increment in BMI was associated with a 16.8% longer console time (95% CI, 4-31.2; P = 0.009), a 17.7% longer instrument active time (95% CI, 4-33.2; P = 0.01), and a higher camera installation rate (incidence rate ratio, 1.36 per +5 kg/m²; 95% CI, 1.07-1.72; P = 0.01). Quantile regression suggested a larger effect in prolonged RARP cases (75th percentile, +45 min per +5 kg/m²; P <⁠0.001).

Higher BMI was associated with longer surgeon-controlled times and increased camera management burden in RARP but not in RAPN. Telemetry may support BMI-adapted scheduling and workflow optimization.