Outcomes and efficacy of robotic-assisted radical prostatectomy using the CMR Versius platform: a prospective study on 118 patients with 1-year follow-up.

OBJECTIVE

To evaluate the outcomes and efficacy of robot-assisted radical prostatectomy (RARP) using the Versius robotic surgical system, aiming to provide comprehensive data on perioperative outcomes, postoperative recovery, and complications.

PATIENT AND METHODS

All cases of RARP using the CMR Versius platform performed at Cairo University Hospital over a two-year period were enrolled in this study. All patients had pathologically confirmed prostate cancer in both localized and locally advanced stages. Data were prospectively collected including preoperative parameters as patients' demographics, serum PSA, and Gleason score after trans-rectal ultrasound guided biopsy. Intraoperative parameters and complications were assessed. Postoperatively, we monitored the oncological and functional outcomes such as continence and sexual functions for at least 12 months. Follow up of PSA was done at 6 weeks, 3 and 6 months, postoperatively.

RESULTS

One-hundred-and-eighteen patients continued the follow-up till 12 months. The median patient age was 64.26 ± 7.13 years. The median PSA value at diagnosis was 9 (4.16-64) ng/ml and the median prostate size was 50 (20-167) grams. The mean docking time, console time, and the total operative time were 13.17 ± 1.157, 194.75 ± 24.3 and 225.76 ± 25 min, respectively and the median blood loss was 307.46 ± 61.44 ml. The mean hospital stay and the mean catheter time were 2.16 ± 0.867 and 7.26 ± 1.441 days, respectively. Forty-nine patients underwent nerve-sparing RARP (bilateral in 41 patients and unilateral in 8 patients). Post-operative continence and potency showed progressive improvement over time during follow-up. Twelve months postoperatively, 90.7% of patients were totally continent and 49% of those patients who underwent nerve-sparing RARP (24/49) were potent.

CONCLUSION

With a positive safety profile and a successful oncological outcome, the use of the CMR system for robot-assisted radical prostatectomy presents a safe and promising method in the surgical management of prostate cancer.