Assessing the Feasibility and Safety of the Toumai® Robotic System in Urologic Surgery: Initial Experience

J Endourol. 2024 Mar 12. doi: 10.1089/end.2024.0028. Online ahead of print.

Abstract

Purpose Robotic surgery using da Vinci surgical system has gained prominence in urology, emerging robotic platforms are expanding its applications and increasing affordability. We assess the feasibility and safety of a novel system, the Toumai® robotic system in various urological surgeries. Methods This prospective study was conducted at the first affiliated hospital of Zhengzhou university. Twenty consecutive patients underwent renal and prostatic surgery with the Toumai®. The study assessed technical feasibility (conversion rate) and safety (perioperative complications) of the procedures as primary outcomes. Secondary endpoints included key surgical perioperative outcomes; functional and oncologic results. The Endoscopic Surgical System operates within a master-slave protocol, comprising a Surgeon Console, Patient Platform, and Vision Platform Results Seventeen patients underwent various nephrectomy procedures and three underwent radical prostatectomy. There was no conversion to alternative surgical approach, a single (Clavien-Dindo grade ≥3b) complication occurred and no readmission was recorded within 30 days. The median operative time was 120, 140, and 210 minutes for partial nephrectomy, radical nephrectomy and radical prostatectomy respectively. Off clamp partial nephrectomy was performed in one case and the warm ischemia time in the remaining two case was eighteen minutes. The median docking time was 22 minutes for nephrectomy and 20 minutes for radical prostatectomy, no major robotic malfunction was encountered. At three months follow-up, no tumor recurrence was recorded, renal function was well preserved and the continence status was satisfactory. Conclusions We present the initial clinical utilization of an innovative robotic platform. Complex urological interventions were successfully completed without conversions and with minimal complications. Further investigations are warranted to confirm these initial findings.