Revo-i vs Da Vinci in Robotic Partial Nephrectomy: First Human Comparison

Area of Science:

• Urology
• Surgical Robotics
• Oncology

Background:

• Robot-assisted partial nephrectomy (RAPN) is dominated by the da Vinci system, but its high cost limits accessibility.
• The Revo-i surgical robot presents a more affordable alternative, though its clinical application in partial nephrectomy (PN) is less established.
• This study is the first to clinically compare perioperative outcomes between the Revo-i and da Vinci Xi systems for RAPN.

Purpose of the Study:

• To compare the perioperative outcomes of RAPN using the Revo-i versus the da Vinci Xi surgical system.
• To evaluate the efficacy and safety of the Revo-i system as a cost-effective alternative for partial nephrectomy.

Main Methods:

• A retrospective study of 124 patients undergoing RAPN between September 2023 and October 2025.
• Patients were treated with either the da Vinci Xi (n=79) or Revo-i (n=45) system, selected via shared decision-making.
• Tumor complexity was assessed using the R.E.N.A.L. nephrometry score; the primary outcome was trifecta achievement (negative margins, WIT <25 min, no complications).

Main Results:

• Overall trifecta achievement rates were similar (Revo-i: 66.7% vs. da Vinci Xi: 57.0%, p=0.342).
• For low-complexity tumors, Revo-i demonstrated shorter warm ischemia time (WIT) due to a higher rate of zero-ischemia cases.
• For high-complexity tumors, Revo-i showed significantly longer WIT (50 vs. 33 minutes, p=0.005) and no trifecta achievements.

Conclusions:

• The Revo-i system shows comparable perioperative outcomes to the da Vinci Xi for low- and intermediate-complexity partial nephrectomies.
• Caution is advised when using the Revo-i system for high-complexity renal tumors due to prolonged warm ischemia times.
• Revo-i offers a viable, cost-effective option for specific RAPN patient populations.