Open vs. robotic prostatectomy using Versius^®: perioperative, oncologic & learning curve outcomes.

Authors

Bara M Hammadeh, Mohannad Abuhamad, Rami Ghanem

Published in

Journal of robotic surgery. Volume 20. Issue 1. Aug 11, 2026. Epub Aug 11, 2026.

Abstract

To compare perioperative, oncologic, and learning curve outcomes between open radical prostatectomy (ORP) and Versius^®-assisted robot-assisted radical prostatectomy (RARP) in Jordan. This prospective observational case series included 133 patients (58 ORP, 75 RARP) treated at King Hussein Cancer Center (open cohort, June 2015-February 2024; robotic cohort, February 2022-December 2025). Baseline characteristics, perioperative parameters, pathologic outcomes, and complications were compared using Wilcoxon rank-sum, Chi-square, and Fisher's exact tests. Multivariable regression adjusted for confounders. The learning-curve analysis used total operative time as the primary endpoint (console time co-primary), with data-driven breakpoint identification and CUSUM analysis. The primary surgeon had prior experience with open and da Vinci-assisted radical prostatectomies before Versius® implementation. RARP was associated with significantly longer operative time (median 360 vs. 255 min; p < 0.001) but lower estimated blood loss (200 vs. 700 mL; p < 0.001). Median hospital stay was 3 days in both groups, but open patients were more likely to stay ≥ 4 days (40.4% vs. 14.0%; p = 0.003). Positive surgical margin rates were similar (53.3% vs. 51.1%; p = 0.813). Lymph node yield was lower in the robotic cohort (median 9 vs. 19; p < 0.001). Operative and console time improved systematically with case number (ρ = -0.65 and - 0.70; both p < 0.001), with a data-driven efficiency transition around case 30 corroborated by CUSUM analysis; the blood-loss advantage was present from the earliest cases whereas the lymph-node-yield deficit persisted beyond the learning curve. Pathologic Gleason score, not surgical approach, independently predicted biochemical recurrence (OR 2.41; p = 0.008). Versius®-assisted RARP achieves lower blood loss and comparable short-term oncologic outcomes to ORP, with operative efficiency improving beyond case 30. Lymph node yield during early adoption requires prospective monitoring. These findings provide an evidence-based framework for centers adopting this emerging platform.

PMID:
42579233
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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