Robotic-assisted radical prostatectomy using the Toumai system: initial single-center experience in Morocco

Robotic surgery has recently emerged in Morocco, mainly in the urological field. We evaluated the feasibility, safety, and early outcomes of robot-assisted radical prostatectomy (RARP) using the new Toumai MT-1000 surgical system in a single-center experience. We prospectively included 132 consecutive patients who underwent RARP, between December 2024 and October 2025, with at least 3 months of follow-up. All procedures were performed by a single experienced surgeon using a standardized transperitoneal anterior approach. Perioperative, pathological, and early functional outcomes were analyzed. The median age was 66 years (IQR: 62-70) and median preoperative PSA was 6.4 ng/ml (IQR: 5.3-8.7). Median operative time was 155 min and median blood loss was 126 mL. No conversions or device-related failures occurred. Positive surgical margins were observed in 6%. Only minor complications occurred, in 6% of patients (Clavien-Dindo grade < IIIb). Continence rates were 30% at catheter removal, 83% at 6 weeks, and 92% at 3 months. Among the 118 patients who underwent nerve-sparing, 55 completed the 3-month IIEF-5 questionnaire. Overall, 35% (19/55) were classified as potent (score ≥ 17). Early biochemical recurrence was observed in 3 patients (2.3%) including two patients with positive surgical margins and one patient with occult metastatic disease identified postoperatively. Toumai-assisted RARP appears feasible in a high-volume Moroccan tertiary care setting. However, given the single-surgeon design, short follow-up and lack of comparator, these findings remain preliminary and require confirmation in multicenter comparative studies with longer follow-up.