Feasibility and safety assessment of the AGIBOT robotic system in urological surgery: preliminary results from a multicenter study.

Background: Robotic-assisted surgery has become a standard approach for urological procedures, providing enhanced precision, dexterity, and minimally invasive benefits. However, high costs and limited accessibility limits its broader adoption. This study evaluates feasibility and safety of novel AGIBOT robotic system in complex urological surgeries.

Methods: This prospective, multicenter study evaluated 59 patients undergoing AGIBOT assisted partial nephrectomy (PN, n = 37) or radical prostatectomy (RP, n = 22) between December 2023 and May 2024. Primary outcomes assessed feasibility (successful surgery without conversion) and safety (absence of major intraoperative complications). Secondary outcomes included operative time, docking time, estimated blood loss, warm ischemia time, hospital stay, functional recovery, and surgical margin status.

Results: All procedures were completed successfully without conversions or major intraoperative complications. For partial nephrectomy, the median operative time was 64 min, blood loss was 50 mL, and median warm ischemia time was 16.5 min, with negative surgical margins in all but one case. For radical prostatectomy, the median operative time was 114.5 min, blood loss was 100 mL, and positive surgical margins were observed in four cases (18%). Renal function remained stable after partial nephrectomy, immediate continence was achieved in 30% of RP patients, improving to full continence at six months in all patients. Two postoperative complications occurred but were not considered related to the robotic system. No major device-related malfunctions were observed and none of the patient's required readmission within 30 days.

Conclusions: The AGIBOT robotic system was feasible and safe for complex urological surgeries, with promising early oncological and functional outcomes. These findings suggest AGIBOT as a reliable platform for robotic surgery, although larger, long-term studies are needed to validate these preliminary results.