Augmented reality in robotic urology: from 3D printed models to cognitive surgical systems. A systematic literature...

Robotic urological surgery has evolved to become the foundation of contemporary, minimally invasive surgical care. However, current robotic platforms lack imaging systems with contextual interpretation and predictive capabilities, although they provide high resolution imaging. Augmented reality combining contemporary imaging technology and guidance from artificial intelligence and machine learning systems-have the potential to immensely improve robotic surgical training, intraoperative navigation and surgical decision making, in order to ultimately make robotic urological surgery safer with better outcomes. With this review article we systematically investigated recent advances in augmented reality (AR) technology, artificial intelligence guided AR, and their applications into robotic urological procedures. A systematic search of the available literature was conducted following the PRISMA guidelines from Pubmed and Cochrane databases, for studies published between 2015 and 2026. After title and abstract screening, 67 full-text articles were assessed, and 38 studies met inclusion criteria for final qualitative synthesis. A systematic literature review was conducted because of the low quality of data available and relatively high risk of bias. Studies analyzing applications of augmented reality navigation in intraoperative tissue characterization, and predictive surgical guidance, in the context of robotically assisted urological surgery, have been included in our review. The use of AR in robotic-assisted radical prostatectomy (RARP) has shown the potential to reduce the rate of positive surgical margins, while also improving continence and erectile function recovery. In robotic-assisted partial nephrectomy (RAPN), AR displays capabilities in reducing warm ischemia time and increasing healthy parenchyma preservation. Challenges related to clinical validation, data standardization, and ethical considerations are also discussed. Augmented reality is poised to redefine robotic urology by enabling real-time, context-aware surgical perception with predictive capabilities, although further research with prospective randomized controlled trials is essential to translate these technologies into clinical practice.