| Keywords [eng] |
Versius Surgical Robotic System, Robot-assisted surgery, Radical prostatectomy, Partial nephrectomy, Learning curve, Minimally invasive surgery, Urology, CMR |
| Abstract [eng] |
Objective: This literature review aims to summarize the current body of evidence on the use of the Versius Surgical Robotic System in prostate and kidney surgery, focusing on early clinical experiences. Background: Minimally invasive surgery (MIS) has transformed urologic practice by reducing patient morbidity and accelerating recovery, still traditional laparoscopy remains challenging due to limited dexteritiy and ergonomics. The Versius Surgical Robotic System (Versius), comprising modular bedside units and an open console with 7 degrees of freedom instrumentation, is designed to address these limitations through enhanced flexibility, surgeon ergonomics and reduced surgical footprint. Methods: This systematic literature review, conducted from November 2023 to March 2025 evaluates the early experiences with the Versius in robot-assisted radical (RARP), and simple prostatectomy (RASP), as well as radical (RARN), partial (RAPN), and simple nephrectomy (RASN) presented in 16 clinical studies (10 prostate, 5 kidney, 1 mixed). Data extraction focused on patient demographics and Versius set-up (bedside unit configuration; port placement and surgical approach), key efficiency metrics (set-up, console and total surgery times; conversion rates; estimated blood loss; inpatient stay; complications), and oncological (TNM staging, Gleason or PADUA scores, positive surgical margins; lymph node status) and functional outcomes (PSA levels, urinary continence). Results: Overall, Versius proved feasible and safe in all urological procedures, with low conversion rates (<8%), median estimated blood loss between 100-200 mL, and predominantly Clavien-Dindo grade I-II complications. Prostate series have reported rapid learning curves - with console times stabilizing around 100 minutes after the first cases - and continence rates exceeding 90% at one year. Renal studies demonstrated comparable operative times to established platforms, with positive margin rates of less than 10% for partial nephrectomies. Technical advantages included customizable bedside unit (BSU) placement, open surgeon console for improved communication, and ergonomically designed console with ability for seated or standing position and fully wristed 5mm instruments; limitations included instrument reach in high BMI patients, initial docking complexity and clinically insignificant system alarms delaying surgery. Conclusion: These results support the integration of Versius into urologic practice, although larger, prospective, multicenter studies and long-term follow-up are warranted to validate oncologic equivalence, refine cost-effectiveness analyses, and optimize set-up standardisation. |
