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The Current State of Robotic Surgery in Urology
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The Current State of Robotic Surgery in Urology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 September 2025 | Viewed by 1210

Special Issue Editor

Dr. Luca Di Gianfrancesco

E-Mail Website
Guest Editor
Department of Urology, Humanitas Gavazzeni, Bergamo, Italy
Interests: cystectomy; bladder cancer; prostate cancer; ureterocutaneostomy; urologic oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am pleased to present the Special Issue "The Current State of Robotic Surgery in Urology", with the aim of collecting clinical–surgical updates in the field of urological robotic surgery.

Robotic surgery has effectively replaced open and laparoscopic surgery; all urological interventions can now be performed through the robotic approach, and for many indications, robotic surgery represents the gold-standard technique.

In this Special Issue, in particular, the robotic experience will be shared in terms of consolidation of the technique, selection of patients, dedicated post-operative patient management protocols, implementation and improvement of old surgical indications, new clinical–surgical indications and new technologies applied to robotic surgery.

In this way, the experience of different operational units can be shared, with the aim of defining the state of the art, updating the situation of "robotic" trends and with the aim of increasing the knowledge of all urologists.

The following formats will be considered and accepted: original articles and reviews.

Dr. Luca Di Gianfrancesco
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • robotic surgery
  • urology
  • surgical technique
  • multi-port
  • single port
  • major urological surgery
  • reconstructive surgery
  • robot-assisted radical cystectomy
  • patients’ selection

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Published Papers (2 papers)

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Research

14 pages, 1161 KiB  
Article
Robot-Assisted Radical Cystectomy with Ureterocutaneostomy: A Potentially Optimal Solution for Octogenarian and Frail Patients with Bladder Cancer
by Angelo Porreca, Filippo Marino, Davide De Marchi, Alessandro Crestani, Daniele D’Agostino, Paolo Corsi, Francesca Simonetti, Susy Dal Bello, Gian Maria Busetto, Francesco Claps, Aldo Massimo Bocciardi, Eugenio Brunocilla, Antonio Celia, Alessandro Antonelli, Andrea Gallina, Riccardo Schiavina, Andrea Minervini, Giuseppe Carrieri, Antonio Amodeo and Luca Di Gianfrancesco
J. Clin. Med. 2025, 14(14), 4898; https://doi.org/10.3390/jcm14144898 - 10 Jul 2025
Viewed by 303
Abstract
Background/Objectives: Robot-assisted radical cystectomy (RARC) has become the primary approach for treating bladder cancer, replacing the traditional open procedure. The robotic approach, when combined with ureterocutaneostomy (UCS), offers significant advantages for octogenarians, who are at increased risk for perioperative complications. Methods: This observational, [...] Read more.
Background/Objectives: Robot-assisted radical cystectomy (RARC) has become the primary approach for treating bladder cancer, replacing the traditional open procedure. The robotic approach, when combined with ureterocutaneostomy (UCS), offers significant advantages for octogenarians, who are at increased risk for perioperative complications. Methods: This observational, prospective, multicenter analysis is based on data from the Italian Radical Cystectomy Registry (RIC), collected from January 2017 to June 2020 across 28 major urological centers in Italy. We analyzed consecutive male and female patients undergoing radical cystectomy (RC) and urinary diversion via the open, laparoscopic, or robot-assisted technique. Inclusion criteria: patients aged 80 years or older, with a WHO Performance Status (PS) of 2–3, an American Society of Anesthesiologist score ≥3, a Charlson Comorbidity Index (CCI) ≥ 4, and a glomerular filtration rate (GFR) <60 mL/min. Results: A total of 128 consecutive patients were included: 41 underwent RARC with UCS (Group 1), 65 open RC (ORC) with UCS (Group 2), and 22 laparoscopic RC (LRC) with UCS (Group 3). The cystectomy operative time was longer in robotic surgeries, while the lymph node dissection time was shorter. RARC with UCS showed statistically significant advantages in terms of lower median estimated blood loss (EBL), transfusion rate, and length of hospital stay (LOS) compared to open and laparoscopic procedures. Intra- and postoperative complications were also lower in the RARC groups. Conclusions: Robotic cystectomy in high-volume referral centers (≥20 cystectomies per year) provides the best outcome for fragile patients. Beyond addressing the baseline pathology, RARC with UCS may represent a leading option, offering oncological control while reducing complications in this vulnerable age group. Full article
(This article belongs to the Special Issue The Current State of Robotic Surgery in Urology)
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9 pages, 933 KiB  
Article
Evaluation of the New Robotic Platform “HINOTORI™” in Urologic Robot-Assisted Surgery: From a Comparison with da Vinci® Surgical System in Sacrocolpopexy
by Tetsuya Fukumoto, Takatora Sawada, Keigo Nishida, Tomoya Onishi, Ryuta Watanabe, Kenichi Nishimura, Noriyoshi Miura, Yuki Miyauchi, Tadahiko Kikugawa and Takashi Saika
J. Clin. Med. 2025, 14(9), 2954; https://doi.org/10.3390/jcm14092954 - 24 Apr 2025
Viewed by 542
Abstract
Background/Objectives: HINOTORI™ is a robotic-assisted surgical platform developed in Japan. It has been applied in urologic procedures such as robot-assisted radical prostatectomy (RARP) and partial nephrectomy (RAPN). This study aimed to evaluate the clinical performance of HINOTORI™ compared with the da Vinci® [...] Read more.
Background/Objectives: HINOTORI™ is a robotic-assisted surgical platform developed in Japan. It has been applied in urologic procedures such as robot-assisted radical prostatectomy (RARP) and partial nephrectomy (RAPN). This study aimed to evaluate the clinical performance of HINOTORI™ compared with the da Vinci® surgical system by analyzing outcomes of robot-assisted sacrocolpopexy (RSC) performed by a single skilled surgeon using a uniform surgical procedure. Methods: A total of 125 patients who underwent RSC for pelvic organ prolapse (POP) were analyzed. Surgical outcomes were compared between the HINOTORI™ (h-RSC group) and da Vinci® (d-RSC group) platforms. Evaluated parameters included operative time, robotic console time, anterior compartment dissection time, suture time per stitch, perioperative complications, hospital stay, and POP recurrence. Results: Operative and robotic console times were significantly longer in the h-RSC group (148 vs. 139 min, p < 0.005; 109 vs. 95 min, p < 0.001). Anterior compartment dissection time showed no significant difference (p = 0.58), but suture time per stitch was longer in the h-RSC group (76 vs. 60 s, p < 0.005), possibly due to limited suture-cutting functionality, requiring manual assistance. No significant differences were observed in perioperative complications, hospital stay, and POP recurrence. Conclusions: HINOTORI™ demonstrated surgical precision and safety comparable to the da Vinci® surgical system. It may serve as a viable alternative robotic platform, supporting broader adoption of robot-assisted surgical technologies. Full article
(This article belongs to the Special Issue The Current State of Robotic Surgery in Urology)
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