Robot-assisted radical prostatectomy (RARP) has become the standard surgical approach for localized prostate cancer. While high-volume centers with experienced surgeons have established benchmarks for perioperative, oncological, and functional outcomes, it is crucial to evaluate whether centers in the early learning phase can achieve comparable results, especially with the support of advanced robotic platforms like the Da Vinci system. Objective :To compare the perioperative, short-term oncological, and functional outcomes of the first 100 patients undergoing RARP at our newly established robotic surgery center with data from high-volume centers reported in contemporary literature.

This retrospective study included 100 consecutive RARP cases performed by surgeons in the early phase of their robotic surgery experience. Patient demographics (age, clinical T-stage, PSA, BMI,Oncological outcomes Gleason score), perioperative parameters (operative time, docking time, console time, blood loss, transfusion rate, complication rate), and recovery metrics (catheter removal time, drain removal time, hospital stay) were analyzed. Oncological outcomes (positive surgical margin rate, biochemical recurrence) and functional outcomes (continence and erectile function rates) were compared against published data from high-volume centers.

Our center demonstrated comparable outcomes in blood loss (mean 158 mL), transfusion rate (1.9%), Oncological outcomes and complication rate (8.7%) to high-volume centers. Although operative and console times were longer, and time to continence was slightly delayed, the final continence rate at 12 months (94.6%) and positive surgical margin rate (21.7%) were within global benchmarks. Erectile dysfunction was reported in 70% of cases at 12 months, significantly higher than literature averages.

Despite being in our early phase, we achieved perioperative, oncological, and functional outcomes comparable to high-volume institutions. The robotic platform plays a critical role in standardizing outcomes, demonstrating that new centers can offer high-quality care as they progress along the learning curve.