Vol. 7, Issue 2, Part B (2025)

Objective: To evaluate early oncological and functional outcomes of Robot-Assisted Radical Prostatectomy (RALRP) performed using a novel surgical robotic platform (Versius, Cambridge Medical Robotics, United Kingdom) in India, focusing on trifecta outcomes (cancer control, continence, potency).
Methods: In this prospective observational study (n = 38), patients with clinically localised prostate cancer underwent RALRP using the Versius system between 2022-2024. Perioperative parameters (operative time, blood loss, hospital stay, catheterisation) and pathological outcomes (positive surgical margins, upstaging, nodal status) were recorded and analysed. Follow-up at 6, 12, 24 weeks’ post-surgery for PSA levels (biochemical recurrence defined as PSA ≥0.2 ng/mL), urinary continence (ICIQ-UI SF), and erectile function (IIEF-5) was scheduled.
Results: Mean operative time was 311 minutes (range 180-490), decreasing with experience. No patients required transfusion. Mean hospital stay was 6.8 days; catheter in situ for mean 10 days. Pathological upstaging occurred in ~63% of cases; positive surgical margins (PSM) in 42.1%, predominantly focal (<3 mm). All patients were biochemically recurrence-free at 24 weeks. Urinary continence improved over time: mean ICIQ-UI SF score from ~13.3 at 6 weeks to ~5.6 at 24 weeks. Erectile function declined early with a partial recovery seen by 24 weeks (mean IIEF-5: preoperative ~12.7 vs ~7.7 at 24 weeks).
Conclusion: Early experience with RALRP using the Versius platform in India demonstrates that satisfactory oncological control and encouraging urinary continence recovery are achievable, even during the learning curve. Erectile function recovery is modest in the short term. These findings support further adoption and longer-term evaluation of newer robotic platforms in resource-limited settings.