{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:04:31Z","timestamp":1792793071703,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Prostate cancer (PCa) imposes a substantial global health burden, with robot-assisted radical prostatectomy (RARP) established as the gold standard for localized disease. While da Vinci\u00ae Xi maintains market dominance, Toumai\u00ae MT-1000 offers a potentially cost-competitive alternative lacking prospective validation. Objective: To evaluate perioperative safety, oncologic quality (primary endpoint: positive surgical margins), early functional recovery (continence), and surgeon learning curve between Toumai\u00ae MT-1000 (T-RARP) and da Vinci\u00ae Xi RARP (DV-RARP) performed in high-volume European practice. Materials and Methods: This is a prospective single-center comparative study carried out at Policlinico Gemelli, Rome (May\u2013November 2025), enrolling 80 patients with localized or locally advanced PCa, elected for radical prostatectomy and casually allocated to receive surgery with Toumai or the da Vinci robotic platform. The primary endpoint was the comparison of positive surgical margin (PSM) rates. Secondary endpoints included the comparison of operative time (skin-to-skin), estimated blood loss, length of hospital stay, 45-day postop outcomes, specifically Clavien\u2013Dindo complications, urinary continence recovery (0\u20131 pad\/day), and IIEF-5 scores. Learning curve was evaluated through the cumulative summation (CUSUM) analysis of operative times and linear regression of operative times (n = 80 cases). The analyses used STATA 19 with two-sided tests at p &lt; 0.05 significance. Results: Baseline characteristics showed balance between cohorts (p &gt; 0.05 for most covariates). Perioperative outcomes proved equivalent: median operative time (OT) was 192.5 min (IQR 165\u2013230) for Toumai\u00ae versus 183.5 min (IQR 147\u2013225) for da Vinci\u00ae Xi (p = 0.38); estimated blood loss (EBL) was 150 mL in both groups (p = 0.87); length of hospital stay (LOS) was 2 days in both groups (p = 0.92). PSM rates were identical at 17.5% (p = 0.79). Continence recovery reached 72.5% versus 80% (p = 0.43). Complications (Clavien\u2013Dindo \u2265 II) occurred in 7.5% versus 12.5% of cases (p = 0.45). The CUSUM analysis demonstrated operative time proficiency after only four procedures; operative time regression showed no significant trend (p = 0.38). Conclusions: Toumai\u00ae MT-1000 demonstrates similar performance to da Vinci\u00ae Xi across different RARP quality metrics, with no detectable learning curve for surgeons previously experienced with da Vinci. These findings support a safe integration of cost-effective platforms into clinical practice, pending multicenter randomized confirmation.<\/jats:p>","DOI":"10.3390\/cancers18091321","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:01:24Z","timestamp":1776848484000},"page":"1321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early Postoperative Outcomes with the Toumai\u00ae Surgical System for Robot-Assisted Radical Prostatectomy: A Prospective Comparative Study with da Vinci\u00ae"],"prefix":"10.3390","volume":"18","author":[{"given":"Bernardo","family":"Rocco","sequence":"first","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Presutti","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2285-8231","authenticated-orcid":false,"given":"Antonio","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9963-3499","authenticated-orcid":false,"given":"Giuseppe","family":"Pallotta","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-9486","authenticated-orcid":false,"given":"Pierluigi","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Life Science, Health, and Health Professions, Unilink University, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mastrovito","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Assumma","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Maria","family":"Turri","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Panio","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5141-7527","authenticated-orcid":false,"given":"Francesco","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8884-6573","authenticated-orcid":false,"given":"Giovanni Battista","family":"Filomena","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9994-4316","authenticated-orcid":false,"given":"Filippo","family":"Gavi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Cavarra","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7357-2974","authenticated-orcid":false,"given":"Or","family":"Schubert","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Balocchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1349-7696","authenticated-orcid":false,"given":"Carlo","family":"Gandi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0464-0788","authenticated-orcid":false,"given":"Nazario","family":"Foschi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Totaro","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Sighinolfi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Liu, X., and Jiang, H. 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