Early implementation of the versius robotic platform in urologic oncology: a prospective experience from an African tertiary center

Abstract Background Access to robotic surgery in many African settings remains limited due to cost and infrastructure constraints. The Versius ® robotic system (CMR Surgical, Cambridge, UK) represents a modular next-generation platform designed to enhance flexibility and scalability. Clinical data regarding early institutional adoption in urologic oncology remain limited, particularly from African centers. This study evaluated perioperative outcomes during initial implementation of the Versius system in a tertiary African urologic oncology center. Methods In this prospective single-center observational study, 45 consecutive patients underwent robot-assisted surgery for suspected or confirmed urologic malignancies using the Versius ® system between May 2023 and May 2024. The primary endpoint was perioperative safety, assessed by intraoperative events and postoperative complications classified according to the Clavien–Dindo system. Secondary endpoints included docking time, console time, operative time, estimated blood loss, transfusion rate, conversion rate, and length of hospital stay. A subgroup analysis compared operative performance across two consecutive six-month periods for radical prostatectomy. Results Procedures included radical prostatectomy ( n = 26), radical cystectomy ( n = 5), radical nephrectomy ( n = 3), partial nephrectomy ( n = 8), nephroureterectomy ( n = 2), and adrenalectomy ( n = 1). The mean operative time for radical prostatectomy was 307.8 ± 84 min. Overall, postoperative complications occurred in 10 patients (22.2%), with major complications (Clavien grade ≥ III) in three patients (6.7%). Conversion to laparoscopy or open surgery was required in six cases (13.3%), predominantly during the early adoption phase. Docking time for radical prostatectomy decreased significantly during the second half of the study period ( p = 0.046). Conclusions Initial institutional experience with the Versius ® robotic system demonstrated technical feasibility and acceptable early perioperative outcomes during platform introduction in an African tertiary center. These findings represent exploratory early-adoption data and should be interpreted within the context of IDEAL stage 1/2a surgical innovation. Larger multicenter studies with longer follow-up are required to evaluate long-term oncologic and functional outcomes.