Innovations in Robot-Assisted Surgery for Genitourinary Cancers: Emerging Technologies and Clinical Applications
Source abstract
Abstract
Robot-assisted surgery has transformed the landscape of genitourinary cancer treatment, offering enhanced precision, reduced morbidity, and improved recovery compared to open or conventional laparoscopic approaches. As the field matures, a new generation of technological innovations is redefining the boundaries of what robotic systems can achieve. This narrative review explores the integration of artificial intelligence, advanced imaging modalities, augmented reality, and connectivity in robotic urologic oncology. The applications of machine learning in surgical skill evaluation and postoperative outcome predictions are discussed, along with AI-enhanced haptic feedback systems that compensate for the lack of tactile sensation. The role of 3D virtual modeling, intraoperative augmented reality, and fluorescence-guided surgery in improving surgical planning and precision is examined for both kidney and prostate procedures. Emerging tools for real-time tissue recognition, including confocal microscopy and Raman spectroscopy, are evaluated for their potential to optimize margin assessment. This review also addresses the shift toward single-port systems and the rise of telesurgery enabled by 5G connectivity, highlighting global efforts to expand expert surgical care across geographic barriers. Collectively, these innovations represent a paradigm shift in robot-assisted urologic oncology, with the potential to enhance functional outcomes, surgical safety, and access to high-quality care.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Renal cell carcinoma treatment · Prostate Cancer Diagnosis and Treatment · Advanced Radiotherapy Techniques
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio Hospital, 15126 Athens, Greece
School of Science and Technology, Hellenic Open University, 26335 Patras, Greece
Royal National Orthopaedic Hospital, London W1W 5AQ, UK
First Department of Urology, Metropolitan General Hospital, 15562 Athens, Greece
References (62)
Show source-provided references
1. Urologic Robotic Surgery10.1016/j.suc.2019.12.003 ↗
2. Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer
3. Bellos, T., Manolitsis, I., Katsimperis, S., Juliebø-Jones, P., Feretzakis, G., Mitsogiannis, I., Varkarakis, I., Somani, B.K., and Tzelves, L. (2024). Artificial Intelligence in Urologic Robotic Oncologic Surgery: A Narrative Review. Cancers, 16.10.3390/cancers16091775 ↗
4. Endoscopic scene labelling and augmentation using intraoperative pulsatile motion and colour appearance cues with preoperative anatomical priors10.1007/s11548-015-1331-x ↗
5. Video labelling robot-assisted radical prostatectomy and the role of artificial intelligence (AI): Training a novice
6. Prediction of complication related death after radical cystectomy for bladder cancer with machine learning methodology10.1080/21681805.2019.1665579 ↗
7. Utilizing Machine Learning and Automated Performance Metrics to Evaluate Robot-Assisted Radical Prostatectomy Performance and Predict Outcomes10.1089/end.2018.0035 ↗
8. A deep-learning model using automated performance metrics and clinical features to predict urinary continence recovery after robot-assisted radical prostatectomy10.1111/bju.14735 ↗
9. Dai, Y., Abiri, A., Pensa, J., Liu, S., Paydar, O., Sohn, H., Sun, S., Pellionisz, P.A., Pensa, C., and Dutson, E.P. (2019). Biaxial sensing suture breakage warning system for robotic surgery. Biomed. Microdevices, 21.10.1007/s10544-018-0357-6 ↗
10. Three-dimensional Augmented Reality-guided Robotic-assisted Kidney Transplantation: Breaking the Limit of Atheromatic Plaques10.1016/j.eururo.2022.07.003 ↗
11. “Augmented reality” applications in urology: A systematic review10.23736/S2724-6051.22.04726-7 ↗
12. Three-dimensional Virtual Models’ Assistance During Minimally Invasive Partial Nephrectomy Minimizes the Impairment of Kidney Function10.1016/j.euo.2021.04.001 ↗
13. Three-dimensional Augmented Reality Robot-assisted Partial Nephrectomy in Case of Complex Tumours (PADUA ≥10): A New Intraoperative Tool Overcoming the Ultrasound Guidance10.1016/j.eururo.2019.11.024 ↗
14. Assessment of surgical skills by using surgical navigation in robot-assisted partial nephrectomy10.1007/s11548-019-01980-8 ↗
15. Surgical Navigation Improves Renal Parenchyma Volume Preservation in Robot-Assisted Partial Nephrectomy: A Propensity Score Matched Comparative Analysis10.1097/JU.0000000000000709 ↗
16. Sica, M., Piazzolla, P., Amparore, D., Verri, P., De Cillis, S., Piramide, F., Volpi, G., Piana, A., Di Dio, M., and Alba, S. (2023). 3D Model Artificial Intelligence-Guided Automatic Augmented Reality Images during Robotic Partial Nephrectomy. Diagnostics, 13.10.3390/diagnostics13223454 ↗
17. Augmented Reality Robot-assisted Radical Prostatectomy: Preliminary Experience10.1016/j.urology.2018.01.028 ↗
18. Augmented-reality robot-assisted radical prostatectomy using hyper-accuracy three-dimensional reconstruction (HA3D™) technology: A radiological and pathological study10.1111/bju.14549 ↗
19. Three-dimensional Elastic Augmented-reality Robot-assisted Radical Prostatectomy Using Hyperaccuracy Three-dimensional Reconstruction Technology: A Step Further in the Identification of Capsular Involvement10.1016/j.eururo.2019.03.037 ↗
20. Metaverse Surgical Planning with Three-dimensional Virtual Models for Minimally Invasive Partial Nephrectomy10.1016/j.eururo.2023.07.015 ↗
21. A feasible and time-efficient adaptation of NeuroSAFE for da Vinci robot-assisted radical prostatectomy10.1016/j.eururo.2013.12.014 ↗
22. Effect of NeuroSAFE-guided RARP versus standard RARP on erectile function and urinary continence in patients with localised prostate cancer (NeuroSAFE PROOF): A multicentre, patient-blinded, randomised, controlled phase 3 trial10.1016/S1470-2045(25)00091-9 ↗
23. Ex vivo fluorescence confocal microscopy: The first application for real-time pathological examination of prostatic tissue10.1111/bju.14754 ↗
24. Digital Frozen Sections with Fluorescence Confocal Microscopy During Robot-assisted Radical Prostatectomy: Surgical Technique10.1016/j.eururo.2021.03.021 ↗
25. Intraoperative Molecular Positron Emission Tomography Imaging for Intraoperative Assessment of Radical Prostatectomy Specimens10.1016/j.euros.2023.05.017 ↗
26. Intraoperative Optical Biopsy during Robotic Assisted Radical Prostatectomy Using Confocal Endomicroscopy10.1016/j.juro.2015.10.182 ↗
27. Atlas of Ex Vivo Prostate Tissue and Cancer Images Using Confocal Laser Endomicroscopy: A Project for Intraoperative Positive Surgical Margin Detection During Radical Prostatectomy10.1016/j.euf.2019.01.004 ↗
28. Assessment of fiberoptic near-infrared raman spectroscopy for diagnosis of bladder and prostate cancer10.1016/j.urology.2004.12.058 ↗
29. Integration of a Raman spectroscopy system to a robotic-assisted surgical system for real-time tissue characterization during radical prostatectomy procedures10.1117/1.JBO.24.2.025001 ↗
30. The use of indocyanine green in partial nephrectomy: A systematic review
31. Near-infrared fluorescence imaging with intraoperative administration of indocyanine green for robotic partial nephrectomy10.1007/s11934-015-0495-9 ↗
32. Robotic Partial Nephrectomy with Indocyanine Green Fluorescence Navigation10.1155/2020/1287530 ↗
33. Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy10.1111/j.1464-410X.2012.11490.x ↗
34. The Role of 3D Models Obtained from Multiparametric Prostate MRI in Performing Robotic Prostatectomy10.1089/end.2021.0541 ↗
35. Rovera, G., Grimaldi, S., Oderda, M., Finessi, M., Giannini, V., Passera, R., Gontero, P., and Deandreis, D. (2023). Machine Learning CT-Based Automatic Nodal Segmentation and PET Semi-Quantification of Intraoperative (68)Ga-PSMA-11 PET/CT Images in High-Risk Prostate Cancer: A Pilot Study. Diagnostics, 13.10.3390/diagnostics13183013 ↗
36. Pure Single-Site Robot-Assisted Partial Nephrectomy Using the SP Surgical System: Initial Clinical Experience10.1016/j.urology.2018.11.024 ↗
37. Single-Port Robot-Assisted Radical Prostatectomy: First Clinical Experience Using The SP Surgical System10.1016/j.urology.2018.10.025 ↗
38. Single port robotic radical cystectomy with intracorporeal urinary diversion: A case series and review10.21037/tau.2020.01.19 ↗
39. Single-port versus multiport robotic-assisted radical prostatectomy: A systematic review and meta-analysis on the da Vinci SP platform10.1002/pros.24296 ↗
40. Fahmy, O., Fahmy, U.A., Alhakamy, N.A., and Khairul-Asri, M.G. (2021). Single-Port versus Multiple-Port Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis. J. Clin. Med., 10.10.3390/jcm10245723 ↗
41. Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis10.1089/end.2021.0210 ↗
42. Patient surgical satisfaction after da Vinci(®) single-port and multi-port robotic-assisted radical prostatectomy: Propensity score-matched analysis10.1007/s11701-021-01269-6 ↗
43. Pure Single-site Robot-assisted Radical Prostatectomy Using Single-port Versus Multiport Robotic Radical Prostatectomy: A Single-institution Comparative Study10.1016/j.euf.2020.10.006 ↗
44. Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Propensity Score Matching Comparative Study10.1089/end.2021.0660 ↗
45. A Comparison of Perioperative Outcomes Between Single-port and Multiport Robot-assisted Laparoscopic Prostatectomy10.1016/j.eururo.2020.03.031 ↗
46. Comparing the safety and efficacy of single-port versus multi-port robotic-assisted techniques in urological surgeries: A systematic review and meta-analysis10.1007/s00345-023-04711-6 ↗
47. Single-Port vs Multiport Robotic Surgery in Urologic Oncology: A Narrative Review10.1089/end.2024.0528 ↗
48. Single-port versus multiport partial nephrectomy: A propensity-score-matched comparison of perioperative and short-term outcomes
49. Single- versus multi-port robotic partial nephrectomy: A comparative analysis of perioperative outcomes and analgesic requirements10.1007/s11701-021-01271-y ↗
50. Single-Port vs Multiport Robot-Assisted Partial Nephrectomy: A Meta-Analysis
51. Initial Experience with Single-Port Robot-Assisted Radical Cystectomy: Comparison of Perioperative Outcomes Between Single-Port and Conventional Multiport Approaches10.1089/end.2020.1227 ↗
52. Single-port robot-assisted simple prostatectomy: Techniques and outcomes10.1007/s00345-024-04778-9 ↗
53. Outcomes of single-port robotic ureteral reconstruction using the da Vinci SP(®) system10.4111/icu.20230005 ↗
54. Single-Port Robotic Applications in Urology10.1089/end.2022.0600 ↗
55. Transatlantic robot-assisted telesurgery10.1038/35096636 ↗
56. 5G ultra-remote robot-assisted laparoscopic surgery in China10.1007/s00464-020-07823-x ↗
57. Application of 5G technology to conduct tele-surgical robot-assisted laparoscopic radical cystectomy10.1002/rcs.2412 ↗
58. Application of Improved Robot-assisted Laparoscopic Telesurgery with 5G Technology in Urology10.1016/j.eururo.2022.06.018 ↗
59. Telerobot-assisted laparoscopic adrenalectomy: Feasibility study10.1093/bjs/znac279 ↗
60. Ultra-remote robot-assisted laparoscopic surgery for varicocele through 5G network: Report of two cases and review of the literature
61. Tele-robotic distal gastrectomy with lymph node dissection on a cadaver10.1111/ases.13246 ↗
62. Effects of communication delay in the dual cockpit remote robotic surgery system10.1007/s00595-023-02784-9 ↗