Novel multiport robotic systems versus da vinci multiport robotic system in robot-assisted partial nephrectomy: a systematic review and meta-analysis of surgical and oncological outcomes

Robotic surgery is a game-changing innovation in urology. Novel multiport robotic systems’s (MRS) benefits and limitations in renal surgery when compared to Da Vinci MRS need to be fully understood. This study aims to identify variations from the well-known Da Vinci MRS in terms of surgical, oncological, and functional outcomes in patients undergoing robot-assisted partial nephrectomy (RAPN). Our systematic review and meta-analysis screened Pubmed, Web of Science, and Scopus databases, analyzing data from eighteen papers. Of them, 6 studies compared RAPN outcomes in patients between the novel MRS and Da Vinci MRS. Surgical outcomes (surgical times, estimated blood loss, length of hospital stay, Clavien-Dindo grade > 2 complications rate) and oncological outcomes (positive surgical margins rate and trifecta achievement rate) were analyzed using a Sidik-Jonkman method in a random-effects model. The abovementioned eighteen studies involved and included 1204 patients (631 novel MRS and 573 Da Vinci). Six of them were comparative studies between novel MRS and Da Vinci. Meta-analysis between novel MRS and Da Vinci revealed statistically significant differences in terms of docking time (Mean Difference 1.95; 95% CI 0.41–3.5; I2 98.9%; p = 0.01) and console time (Mean Difference 16.72; 95% CI 5.1–28.4; I2 67.7%; p < 0.01). No other variations between the two systems were shown in terms of oncological or perioperative results. The present systematic review and meta-analysis demonstrates similar surgical and clinical outcomes for RAPN conducted with the novel MRS and Da Vinci robotic platform, despite the small number of included studies. Novel MRS could be used in resource-limited hospital settings as alternative to Da Vinci MRS.