Chen Si-Yu, Ma Yongjia, Yang Jian-Wei, Liu Hanlin, Wang Li, Li Xiao-Ran
Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730030, People's Republic of China.
Gansu Province Clinical Research Center for Urology, Lanzhou, People's Republic of China.
J Robot Surg. 2025 Jun 12;19(1):284. doi: 10.1007/s11701-025-02457-4.
This study aims to comprehensively assess the clinical performance of the Versius robotic platform in the context of robot-assisted radical prostatectomy (RARP), focusing on its safety profile, practicality, and postoperative functional recovery, in order to support its integration into urologic cancer management. An extensive literature search was performed using databases including PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov, covering publications up to December 2024. The eligible studies were those reporting on perioperative metrics or functional outcomes associated with Versius-assisted RARP. Data extraction and synthesis were carried out under a single-arm meta-analytic framework. The aggregated measures such as operative duration, intraoperative blood loss, length of hospitalization, complication frequency, positive surgical margin (PSM) rate, and continence outcomes were calculated using Stata 18 SE. The study heterogeneity was quantified via the I statistic and sensitivity tests were performed to explore heterogeneity sources. A total of four studies comprising 145 patients were included. The pooled average duration of surgery was 190.63 min, with a mean blood loss of 320.35 mL. The rate of high-grade complications (Clavien-Dindo > II) was 7%, while the PSM rate stood at 32%. Continence recovery rates at 1, 2 and 3 months post-surgery were 43%, 65%, and 73%, respectively. Considerable inter-study heterogeneity was identified, possibly influenced by differences in surgical proficiency and Versius system configurations. The sensitivity analysis highlighted operative console time as a stable parameter, with reduced heterogeneity after removal of an outlier study. The study demonstrates that the Versius robotic platform achieves comparable oncological and functional results to conventional prostatectomy techniques, with the added advantage of potential cost savings, positioning it as a viable surgical option. Its modular structure and ergonomic enhancements present distinct benefits, although procedural variability persists. Additional high-quality, multi-institutional prospective studies are necessary to substantiate these preliminary findings and inform standardized surgical practices.
本研究旨在全面评估Versius机器人平台在机器人辅助根治性前列腺切除术（RARP）中的临床表现，重点关注其安全性、实用性和术后功能恢复情况，以支持其融入泌尿生殖系统癌症管理。使用包括PubMed、Embase、Web of Science、Cochrane图书馆和ClinicalTrials.gov在内的数据库进行了广泛的文献检索，涵盖截至2024年12月的出版物。符合条件的研究是那些报告与Versius辅助RARP相关的围手术期指标或功能结果的研究。数据提取和合成在单臂荟萃分析框架下进行。使用Stata 18 SE计算手术持续时间、术中失血量、住院时间、并发症发生率、手术切缘阳性（PSM）率和控尿结果等汇总指标。通过I统计量对研究异质性进行量化，并进行敏感性测试以探索异质性来源。总共纳入了四项研究，包括145名患者。汇总的平均手术时间为190.63分钟，平均失血量为320.35毫升。高级别并发症（Clavien-Dindo＞Ⅱ）发生率为7%，而PSM率为32%。术后1、2和3个月的控尿恢复率分别为43%、65%和73%。研究发现存在相当大的研究间异质性，可能受手术熟练程度和Versius系统配置差异的影响。敏感性分析突出了手术控制台时间作为一个稳定参数，在剔除一项异常值研究后异质性降低。该研究表明，Versius机器人平台在肿瘤学和功能方面取得了与传统前列腺切除术技术相当的结果，还有潜在成本节约的额外优势，使其成为一种可行的手术选择。其模块化结构和人体工程学改进具有明显优势，尽管手术过程存在变异性。需要更多高质量、多机构的前瞻性研究来证实这些初步发现并为标准化手术实践提供依据。
