Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Extraperitoneal robot assisted laparoscopic prostatectomy with Versius system: single centre experience

Prostate Cancer and Prostatic Diseases (2024)Cite this article

Subjects

Abstract

Introduction

Versius Surgical System (CMR Surgical, Cambridge, UK) is a novel tele-operated robotic surgical system designed to assist surgeons for minimally invasive surgery which is gaining momentum in the world of robotic surgery. We describe our single centre experience with Versius and report the advantages and challenges posed by this new robotic system in a series of 53 extraperitoneal robotic assisted laparoscopic prostatectomies (eRALP) for prostate cancer (PCa).

Materials and methods

Data of 53 eRALP performed with Versius in our centre were collected and analysed, Descriptive statistics were used to report our results.

Results

In 16 months we performed 53 eRALP: 18 (34%) with PLND, 33 (62%) nerve sparing cases. Mean setup time was 15 min, mean console time was 100 min and mean operative time was 130 min. We observed a substantial reduction of console time and set-up time after only 5 procedures. In the first 4 procedures, the dissection of the neurovascular bundle was performed laparoscopically, to switch back to robotic assisted approach afterwards. No major system failures were observed. No major intra-operative and post-operative complications occurred. Mean follow-up time was 9 months (range 3–15 months); no patients experienced biochemical recurrence or metastatic progression over this period, 8 (15%) patients had adjuvant radiotherapy based on unfavourable pathology report (positive surgical margins or positive limphnodes).

Conclusion

This represents to our knowledge the largest extraperitoneal RALP case series with Versius, and it aims to provide solid clinical proof of the safety, effectiveness and versatility of this innovative system. In our experience, this platform represents a good option for every urologic surgeon who wants to start a robotic programme and it appears particularly suitable for urologists with a large laparoscopic expertise.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Port configuration and BSU set-up.
Fig. 2: Impact of learning curve on console time.

Similar content being viewed by others

Data availability

The data that support the findings of this study are available on request from the author FD.

References

  1. Babbar P, Hemal A. Robot-assisted urologic surgery in 2010—advancements and future outlook. Urol Ann. 2011;3:1–7. https://doi.org/10.4103/0974-7796.75853.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pandolfo SD, Del Giudice F, Chung B, Manfredi C, De Sio M, Damiano R, et al. Robotic assisted simple prostatectomy versus other treatment modalities for large benign prostatic hyperplasia: a systematic review and meta-analysis of over 6500 cases. Prostate Cancer Prostatic Dis. 2022. https://doi.org/10.1038/s41391-022-00616-4.

  3. Collins D, Paterson HM, Skipworth RJE, Speake D. Implementation of the Versius robotic surgical system for colorectal cancer surgery: first clinical experience. Color Dis. 2021;23:1233–8. https://doi.org/10.1111/codi.15568.

    Article  Google Scholar 

  4. Fuschi A, Pastore AL, Al Salhi Y, Martoccia A, De Nunzio C, Tema G, et al. The impact of radical prostatectomy on global climate: a prospective multicentre study comparing laparoscopic versus robotic surgery. Prostate Cancer Prostatic Dis. 2023. https://doi.org/10.1038/s41391-023-00672-4.

  5. Soumpasis I, Nashef S, Dunning J, Moran P, Slack M. Safe implementation of a next-generation surgical robot: first analysis of 2,083 cases in the versius surgical registry. Ann Surg. 2023. https://doi.org/10.1097/SLA.0000000000005871.

  6. Alkatout I, Salehiniya H, Allahqoli L. Assessment of the versius robotic surgical system in minimal access surgery: a systematic review. J Clin Med. 2022;11. https://doi.org/10.3390/jcm11133754.

  7. Koukourikis P, Rha KH. Robotic surgical systems in urology: what is currently available? Investig Clin Urol. 2021;62:14–22. https://doi.org/10.4111/icu.20200387.

    Article  PubMed  Google Scholar 

  8. Thomas BC, Slack M, Hussain M, Barber N, Pradhan A, Dinneen E, et al. Preclinical evaluation of the versius surgical system, a new robot-assisted surgical device for use in minimal access renal and prostate surgery. Eur Urol Focus. 2021;7:444–52. https://doi.org/10.1016/j.euf.2020.01.011.

    Article  PubMed  Google Scholar 

  9. Rocco B, Turri F, Sangalli M, Assumma S, Piacentini I, Grasso A, et al. Robot-assisted radical prostatectomy with the versius robotic surgical system: first description of a clinical case. Eur Urol Open Sci. 2023;48:82–3. https://doi.org/10.1016/j.euros.2022.11.019.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Huddy JR, Crockett M, Nizar AS, Smith M, Malki M, Barber N, et al. Experiences of a “ COVID protected ” robotic surgical centre for colorectal and urological cancer in the COVID-19 pandemic. J Robot Surg. 2022;16:59–64. https://doi.org/10.1007/s11701-021-01199-3.

    Article  PubMed  Google Scholar 

  11. Hussein A, Mohsin R, Qureshi H, Leghari R, Jing Z, Ramahi YO, et al. Transition from da Vinci to Versius robotic surgical system: initial experience and outcomes of over 100 consecutive procedures. J Robot Surg. 2022:419–26. https://doi.org/10.1007/s11701-022-01422-9.

  12. De Nunzio C, Brassetti A, Cancrini F, Prata F, Cindolo L, Sountoulides P, et al. Physical inactivity, metabolic syndrome and prostate cancer diagnosis: development of a predicting nomogram. Metabolites. 2023;13. https://doi.org/10.3390/metabo13010111.

  13. Bokhorst LP, Valdagni R, Rannikko A, Kakehi Y, Pickles T, Bangma CH, et al. A decade of active surveillance in the PRIAS study: an update and evaluation of the criteria used to recommend a switch to active treatment. Eur Urol. 2016;70:954–60. https://doi.org/10.1016/j.eururo.2016.06.007.

    Article  PubMed  Google Scholar 

  14. Dindo D, Demartines N, Clavien P. Classification of surgical complications. Ann Pediatr Surg. 2004;240:205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae.

    Article  Google Scholar 

  15. Scarcia M, Zazzara M, Divenuto L, Cardo G, Portoghese F, Romano M, et al. Extraperitoneal robot-assisted radical prostatectomy: a high-volume surgical center experience. Minerva Urol Nefrol. 2018;70:479–85. https://doi.org/10.23736/S0393-2249.18.03114-4.

    Article  PubMed  Google Scholar 

  16. Haig F, Medeiros ACB, Chitty K, Slack M. Usability assessment of Versius, a new robot-assisted surgical device for use in minimal access surgery. BMJ Surg Inter Heal Technol. 2020;2:1–8. https://doi.org/10.1136/bmjsit-2019-000028.

    Article  Google Scholar 

  17. Sood A, Grauer R, Diaz-Insua M, Tewari KA, Hemal AK, Shrivastava A, et al. 15-year biochemical failure, metastasis, salvage therapy, and cancer-specific and overall survival rates in men treated with robotic radical prostatectomy for PSA-screen detected prostate cancer. Prostate Cancer Prostatic Dis. 2023;26:778–86. https://doi.org/10.1038/s41391-023-00674-2.

    Article  CAS  PubMed  Google Scholar 

  18. Lebeau T, Rouprêt M, Ferhi K, Chartier-Kastler E, Richard F, Bitker MO, et al. Assessing the complications of laparoscopic robot-assisted surgery: the case of radical prostatectomy. Surg Endosc. 2011;25:536–42. https://doi.org/10.1007/s00464-010-1210-z.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. These authors contributed equally: F. Dibitetto, C. Fede Spicchiale

Authors and Affiliations

  1. Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy

    F. Dibitetto, R. Castellucci, S. Sansalone, A. Akhundov, L. Defidio & M. De Dominicis

  2. Department of Urology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK

    C. Fede Spicchiale

Authors
  1. F. Dibitetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Fede Spicchiale
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Castellucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Sansalone
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Akhundov
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Defidio
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. De Dominicis
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors discussed the results and contributed to the final manuscript. F. Dibitetto, C. Fede Spicchiale, S. Sansalone, R. Castellucci and M. De Dominicis developed the idea and the concept of the study. F. Dibitetto, A. Akhundov, L. Defidio collected the data and analysed the results. F. Dibitetto and C. Fede Spicchiale drafted and wrote the article. M. De Dominicis performed the operations and supervised the project.

Corresponding author

Correspondence to C. Fede Spicchiale.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dibitetto, F., Fede Spicchiale, C., Castellucci, R. et al. Extraperitoneal robot assisted laparoscopic prostatectomy with Versius system: single centre experience. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00810-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41391-024-00810-6

Search

Advanced search

Quick links