Robotic urologic surgery using the KangDuo surgical robot 01 system: A single-centre retrospective analysis

Robotic urologic surgery using the KangDuo surgical robot 01 system: A single-centre retrospective analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Robotic urologic surgery using the KangDuo surgical robot 01 system: A single-centre retrospective analysis Dong Zhang, Jinfeng Pan, Zhaoqun Guo, Zejun Yan, Xiaolong Jia, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6839860/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background To explore the clinical application of the three-arm KangDuo robot in urological surgeries. Methods The clinical data of 32 patients who underwent robot-assisted urological surgeries performed by the same surgeon between August 2023 and April 2024 were retrospectively analysed. Twenty of the patients underwent radical prostatectomy, 6 underwent partial nephrectomy, 2 underwent radical nephrectomy, 1 underwent radical cystectomy, 1 underwent pyeloplasty, 1 underwent a retroperitoneal mass resection, and 1 underwent residual ureteral cancer resection. Results All surgeries were successful, and no Clavien–Dindo grade III or higher complications occurred perioperatively. The median age of the patients was 70 (42–82) years. The median docking time was 7.2 (5.8–9.5) minutes. The median operation time was 132 (90–450) minutes. The median intraoperative blood loss volume was 100 (20–300) mL. The median postoperative hospital length of stay was 6 (3–13) days. Conclusions The three-arm KangDuo robot can be safely and effectively used in urological surgeries, but large-scale multicentre studies are needed for further verification. Robotics KangDuo surgical robot Partial nephrectomy Radical prostatectomy Figures Figure 1 Figure 2 Figure 3 Background Minimally invasive surgeries, particularly laparoscopic surgeries, are increasingly being performed. Compared with open surgeries, minimally invasive surgeries result in less bleeding, less postoperative pain and faster postoperative recovery. In traditional laparoscopic surgeries, surgeons stand for a long period with their bodies and arms in uncomfortable positions, and often experience physical fatigue and joint stiffness. Advancements in medical technology have led to the advent of robotic surgical systems. Moreover, because robotic surgical systems are known to filter hand tremors and reduce surgeon fatigue, surgeries can be performed smoothly. In 2000, the world's first laparoscopic surgical robot, da Vinci, was approved for marketing. Compared with laparoscopy, the da Vinci robot provides a high-definition view of the surgical field, filters tremors, and rotates 360°. Therefore, it has been widely used in urological surgeries [ 1 ]. In recent years, an increasing number of surgical robots, such as the Versius, Senhent, and Hugo-RAS robots, have been introduced [ 2 ]. The KangDuo endoscopic surgical robot 01 is the first three-arm laparoscopic surgical robot with an open console approved for marketing by the National Medical Products Administration. Previous single-centre studies have shown that the KangDuo robot is safe and effective for urological surgeries [ 3 ]. This article mainly discusses the clinical application of the three-arm KangDuo robot in laparoscopic urological surgeries at our centre. Materials and methods Patient selection and information The clinical data of 32 patients who underwent laparoscopic urological surgery with the three-arm KangDuo robot between August 2023 and April 2024 were retrospectively analysed. Twenty of the patients underwent radical prostatectomy, 6 underwent partial nephrectomy, 2 underwent radical nephrectomy, 1 underwent radical cystectomy, 1 underwent pyeloplasty, 1 underwent a retroperitoneal mass resection, and 1 underwent radical ureteral resection. The inclusion criteria were as follows: (1) aged 18–80 years; (2) able to tolerate laparoscopic surgery as evaluated preoperatively; and (3) signed an informed consent form specifically for the use of the KangDuo robotic system, in addition to standard surgical consent. The exclusion criteria were as follows: (1) severe cardiopulmonary dysfunction or other conditions unsuitable for laparoscopic surgery; (2) abnormal coagulation function; and (3) an inability to tolerate surgery. Surgical methods and surgeon experience All surgeries were completed by the same surgeon. The surgery was completed using the domestic KangDuo three-arm surgical robot (Fig. 1 a shows the surgical platform). The chief surgeon was in front of the console and wore 3D glasses to observe the three-dimensional image on the display screen (Fig. 1 b). For lower urinary tract surgeries such as radical prostatectomy and radical cystectomy, the general patient position and port placement are shown in Fig. 2 a. For upper urinary tract surgeries such as partial nephrectomy and pyeloplasty, the general patient position and port placement are shown in Fig. 2 b. Finally, guided by the target area, the mechanical arm located at the bedside was guided into the surgical area. Each mechanical arm was connected to a trocar, and the surgery was completed as usual. If the patient's Gleason score was 6 or 7 before surgery and the PSA level was < 10 ng/mL, intrafascial radical prostatectomy was performed during the operation. If the tumour was highly malignant, extrafascial resection and external iliac and obturator lymph node dissection were performed. Observation indicators The observation indicators included general information, docking time, operation time, intraoperative complications, postoperative hospital length of stay, postoperative complications, and postoperative surgical results. The operation time was defined as the time from skin incision to skin closure with sutures. Urinary incontinence was characterized by the use of no more than one pad per day. Data statistics SPSS software was used for statistical analyses. Normally distributed continuous variables are presented as means ± standard deviations. Nonnormally distributed variables are presented as medians. Categorical variables are presented as absolute numbers and percentages. Student's t test was used to compare the data. A P value < 0.05 indicated statistical significance. Results All robotic surgeries were successful. No conversion to open surgery or to laparoscopy occurred. The median age of the patients was 70 (42–82) years. The median docking time was 7.2 (5.8–9.5) minutes. The median operation time was 132 (90–450) minutes. The median intraoperative blood loss volume was 100 (20–300) mL. The median postoperative hospital length of stay was 6 (3–13) days. No Grade III or higher intraoperative or postoperative complications occurred. The mechanical arm operated smoothly and stably during the operation. The effects of intraoperative tissue cutting, electrocoagulation, and haemostasis were good. The relevant data of the various surgeries are summarized below (Table 1 ). Table 1 Surgical data of the 32 enrolled patients who underwent robotic urologic surgery Variables Patients (n) Docking time (min) Operation time (min) Blood loss (mL) Length of stay (days) Radical prostatectomy 20 7.2 (6.3–9.5) 129 (120–180) 100 (50–500) 6 (3–13) Partial nephrectomy 6 7.3 (5.8–7.8) 132 (120–150) 50 (20–200) 5 (3–6) Radical nephrectomy 2 6.9 (6.7–7) 128 (90–165) 65 (50–80) 5 (3–7) Radical cystectomy 1 9 300 100 7 Pyeloplasty 1 7.7 120 20 7 retroperitoneal mass 1 7 450 300 10 Ureteral cancer 1 8.3 180 20 6 Robot-assisted radical prostatectomy All 20 surgeries were successful. The median age of the patients was 71.5 (60–77) years. The preoperative PSA level ranged from 0–45.03 ng/mL. Two patients had a preoperative Gleason score of 3 + 3, 6 had a score of 3 + 4, 4 had a score of 4 + 3, 4 had a score of 4 + 4, 3 had a score of 4 + 5, and 1 had a score of 5 + 4. One patient had clinical stage T3bN1M1b disease before surgery and received endocrine therapy for half a year. Two patients had T3bN0M0 disease, one of whom received endocrine therapy for half a year. The remaining patients had T2cN0M0 disease or lower. The median docking time was 7.2 (6.3–9.5) minutes. The median operation time was 129 (120–180) minutes. The median blood loss volume was 100 (50–500) mL. The median postoperative hospital length of stay was 6 (3–13) days. No postoperative urine leakage was observed. All urinary catheters were removed 2 weeks after surgery. The immediate postoperative urinary continence rate was 45%. The 3-month postoperative urinary continence rate was 90%, and the 6-month postoperative urinary continence rate was 100%. Four intrafascial surgeries were performed. The immediate postoperative urinary continence rate was 75%, and the 3-month postoperative urinary continence rate was 100%. Postoperative pathology revealed prostate adenocarcinoma. Two patients had stage T2 disease before surgery and were upgraded to pT3. Two patients (10%) had positive surgical margins. Robot-assisted partial nephrectomy All 6 surgeries were successful. The median age of the patients was 53 (47–70) years. The preoperative creatinine level was 70 (36–95) µmol/L. The median docking time was 7.3 (5.8–7.8) minutes. The median operation time was 132 (120–150) minutes. The median renal warm ischaemia time was 17.5 (12–24) minutes. The median blood loss volume was 50 (20–200) mL. The median postoperative hospital length of stay was 5 (3–6) days. The postoperative creatinine level was 69.5 (39–92) µmol/L. Postoperative pathology revealed clear cell carcinoma in 3 patients, hamartoma in 2 patients, and chromophobe cell carcinoma in 1 patient. No signs of tumour recurrence were observed at the 3-month follow-up visit. Robot-assisted radical nephrectomy The patients were 82 years old and 64 years old. The docking times were 7 minutes and 6.7 minutes, respectively. The operation times were 90 minutes and 165 minutes. The blood loss volumes were 50 mL and 80 mL, respectively. The postoperative hospital lengths of stay were 3 days and 7 days, respectively. Postoperative pathology revealed clear cell carcinoma in both patients. No signs of tumour recurrence were observed at the 3-month follow-up visit. Robot-assisted radical cystectomy + ileal conduit The patient was 60 years old. The docking time was 9 minutes. The operation time was 300 minutes. The volume of intraoperative blood loss was 100 mL. The mean postoperative hospital length of stay was 7 days. Postoperative pathology revealed high-grade urothelial carcinoma (pT3N1M0). Robot-assisted pyeloplasty The patient was 64 years old. The docking time was 7.7 minutes. The operation time was 120 minutes. The volume of intraoperative blood loss was 20 mL. The mean postoperative hospital length of stay was 7 days. Compared with the condition before surgery, the patient’s hydronephrosis improved after 3 months of follow-up. Robot-assisted retroperitoneal mass resection The patient was 42 years old. Twenty years ago, he was admitted to the hospital due to a left renal contusion caused by a car accident. After discharge, an abdominal mass was found. At that time, puncture and drainage were performed. The drainage fluid was urine. In the past 20 years, the incidence of abdominal masses had gradually increased. Enhanced abdominal CT revealed the following findings: 1. a large space-occupying lesion with necrosis and haemorrhage in the left retroperitoneum; and 2. obvious hydronephrosis of the left kidney was observed (Fig. 3 a). This time, robot-assisted resection of the retroperitoneal mass and left nonfunctioning kidney was performed. The docking time was 7 minutes. The operation time was 450 minutes. Conversion to open surgery was not needed. The volume of intraoperative blood loss was 300 mL. The mean postoperative hospital length of stay was 10 days. Postoperative pathology of the gross specimen suggested a cystic‒solid mass (Fig. 3 b). Pathology revealed an encapsulated nodule with bleeding and calcification in the left retroperitoneum. The mass size was 20*15 cm. The renal parenchyma was atrophic, and interstitial inflammatory cell infiltration was observed. Robot-assisted resection of ureteral cancer The patient was 64 years old. Five years ago, radical resection of right renal pelvic cancer was performed because of the presence of a right renal pelvic tumour. The lower segment of the ureter was not resected during the operation. This time, the patient was admitted to the hospital due to haematuria for 1 day. A CTU examination revealed a space-occupying lesion at the bladder entrance of the lower segment of the right residual ureter. Therefore, robot-assisted resection of residual ureteral cancer was performed. The operation was successfully completed. The docking time was 8.3 minutes. The operation time was 180 minutes. The volume of intraoperative blood loss was 20 mL. The mean postoperative hospital length of stay was 6 days. Postoperative pathology suggested high-grade urothelial carcinoma. No signs of tumour recurrence were observed at the 6-month follow-up visit. Discussion Technological advances have led to major changes in the field of surgery. Laparoscopic and robotic technologies have greatly improved surgical outcomes and the patient prognosis. Laparoscopic surgery is known for its minimal invasiveness, whereas robotic technology has unique advantages in precision and flexibility. In recent years, surgeons have fervently pursued methods to improve the precision and outcomes of urological surgery. Surgical robots, such as the da Vinci robot, represent a new chapter in this field and have been widely used in urological surgeries such as radical prostatectomy and partial nephrectomy [ 4 – 7 ]. At present, many surgical robots have been successfully developed domestically and used in surgical operations owing to technological advances, and surgical robots are expected to be used more frequently in clinical practice. The KangDuo robot has an open console, which allows the surgeon to maintain a comfortable neck and shoulder posture during the operation, thereby significantly reducing the fatigue and discomfort associated with maintaining an unnatural position for prolonged periods. Moreover, multiple screens display high-resolution images, allowing precise navigation, preoperative three-dimensional reconstruction, intraoperative ultrasound, and intraoperative fluorescence guidance to improve surgical precision [ 8 ]. In addition, 5G and a fixed network allow patients to receive treatment from experts at national medical centres and county-level and municipal hospitals. Robots are more commonly used in laparoscopic radical prostatectomy and partial nephrectomy. Tumour control, urinary continence, and preservation of sexual function are the three important indicators for evaluating radical prostatectomy. The robotic system can identify the surrounding anatomy of the prostate under high-definition 3D vision, reducing damage to normal tissues around the urethra. It can operate flexibly in a narrow space, free a urethra of sufficient length, and maximize the preservation of the neurovascular bundle. Therefore, it has a relatively good effect on the recovery of postoperative urinary continence function and erectile function [ 9 , 10 ]. Ma et al. [ 11 ] conducted a meta-analysis of 46 studies. A total of 10,061 patients were included in the robot-assisted radical prostatectomy group and 6,639 patients were included in the laparoscopic radical prostatectomy group. The results showed that robot-assisted radical prostatectomy was superior to laparoscopic radical prostatectomy in terms of the overall urinary continence recovery rate and overall erectile function recovery rate. Fan et al. [ 12 ] performed radical prostatectomy with the KangDuo surgical robot, and the 1-month postoperative urinary continence rate was 87.5%. In this study, the 2-week postoperative urinary continence rate was 45% in 20 patients, the 3-month postoperative urinary continence rate was 90%, and the 6-month postoperative urinary continence rate was 100%, suggesting satisfactory results. In terms of tumour control, among the 15 patients with stage pT2N0M0 disease at 6 weeks after surgery, 14 patients had a PSA level less than 0.02 ng/mL, and 11 patients had a PSA level of 0. Two patients had positive surgical margins, but the PSA level of these two patients was less than 0.02 ng/mL at 6 weeks after surgery. Therefore, endocrine therapy or radiotherapy was not administered. After 3 months of follow-up, the PSA level was 0. According to previous reports, the positive surgical margin rate after da Vinci-assisted radical prostatectomy is 9.1–34%. Lee et al. [ 13 ] reported that 1218 prostate cancer patients underwent robot-assisted laparoscopy. For patients with stage T2 disease, the positive surgical margin rate after surgery was 13.2%, and for patients with stage T3 disease and above, the positive surgical margin rate was 34%. Umari et al. [ 14 ] performed robot-assisted radical prostatectomy on 483 patients with prostate cancer. The results revealed that for patients with stage T2 disease, the positive surgical margin rate was 9.1%, and for patients with stage T3 disease, the positive surgical margin rate was 27.6%. The overall positive surgical margin rate in this study was 10%, which was comparable to that of da Vinci surgery. In partial nephrectomy, due to the limited space in the retroperitoneal cavity, peritoneal rupture may occur, increasing the difficulty of the surgery. Therefore, the transperitoneal approach was used in this study, as it provides a wide space for manoeuvrability of the mechanical arm. However, postoperative ileus may occur after transperitoneal surgery. In this study, after the drainage tube was placed, the perirenal fascia was resutured to reduce the exposure of the surgical wound. After being exhausted on the first day after surgery, the patient was allowed to resume a liquid diet, albeit with a reduced volume. On the second day after surgery, the patient was allowed to resume a semiliquid diet. No signs of ileus were observed at the 3-month follow-up visit. Tumour control and the protection of renal function are important indicators for evaluating the success of partial nephrectomy. Jeffrey et al. [ 15 ] conducted a meta-analysis of 25 studies with a total of 4919 people. Compared with laparoscopic surgery, robot-assisted partial nephrectomy results in a shorter warm ischaemia time, and no significant difference in the positive margin rate is observed. The reason may be that the mechanical arm of the robot surgical system can rotate 360° and can accurately complete fine movements such as cutting, suturing, and knotting. In this study, the surgeon blocked the main renal artery and completely resected the tumour along its edge at a distance of 0.5 cm. During suturing, the assistant used a suction device to ensure a good view of the surgical field and controlled the warm ischaemia time within 25 minutes. No significant differences in renal function were observed before and after surgery, which indicated successful tumour control and preserved renal function. Improvements in clinical manifestations, the relief of hydronephrosis, and improvements in renal function are signs of successful surgery. One pyeloplasty was completed at our centre. The operation was completed smoothly and did not exceed 2 hours. No perioperative complications occurred. Notably, since the mechanical arm cannot provide direct tactile feedback, the surgeon should apply appropriate tension to the suture during the suturing process and maintain an appropriate suture spacing to avoid ureteral tearing. For this patient, a D‒J tube was placed during the operation. Three months after the operation, a re-examination revealed that the degree of hydronephrosis was lower than before, and the patient's symptoms had significantly improved. In addition, radical cystectomy and the resection of a retroperitoneal mass were successfully completed at our centre. Intraoperative bleeding was within a controllable range. The long duration of the operation may be related to the difficulty of the surgery itself. All patients were discharged within 10 days after surgery. In conclusion, the KangDuo robot can be safely and effectively applied in common urological surgeries. This study has the following limitations: (1) the small sample size and confounding factors may have affected the results; (2) the study was a single-centre retrospective study, future prospective studies should prioritize such evaluations. Additionally, (3) the follow-up time was relatively short, which was insufficient to evaluate long-term oncologic control or functional recovery. Extended follow-up studies are warranted to address these questions. Therefore, more multicentre, prospective, and larger-scale randomized trials comparing the KangDuo system with established robotic platforms are warranted to validate its advantages in terms of operative efficiency and oncological outcomes. Conclusions In conclusion, according to our single-centre experience, the application of the three-arm KangDuo robot 01 system in urological surgeries is feasible, safe, and effective. However, large-sample studies with longer follow-up times, as well as multicentre randomized controlled trials, are still needed to further evaluate the effectiveness and safety of this robotic surgical system. Declarations Funding This work was supported by the Ningbo Clinical Research Center for Urological Disease (No. 2019A21001) and the Ningbo Top Medical and Health Research Program (No. 2022020203). Competing Interests The authors have no relevant financial or nonfinancial conflicts of interest to disclose. Author’ contributions Dong Zhang, data collection and manuscript writing. Jinfeng Pan, data collection and data analysis. Zhao qun Guo, data collection. Zejun Yan, manuscript writing. Xiaolong Jia, data collection and critical revision of the manuscript. Junhui Jiang, data analysis and critical revision of the manuscript. Ethical approval and consent to participate This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Ningbo University (No. 221RS-01). The ethics declaration is in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in this study. Consent for publication The authors affirm that the human research participants provided informed consent for publication. Data Availability Statement The datasets generated and/or analysed during the current study are not publicly available due to national regulations on personal data protection but are available from the corresponding author upon reasonable request. Acknowledgements Not applicable. References Autorino R, Nathan S. Robotic surgery in urology: recent advances. Asian J Urol. 2023;10:385–7. https://doi.org/10.1016/j.ajur.2023.08.005 . Cannoletta D, Gallioli A, Mazzone E. A global perspective on the adoption of different robotic platforms in uro-oncological surgery. Eur Urol Focus.2025. https://doi.org/10.1016/j.euf.2025.03.016 Xiong SW, Fan S, Chen SB, Wang X, Han GP, Li Z, et al. Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: a single-center prospective analysis. Chin Med J. 2023;136:2960–6. https://doi.org/10.1097/cm9.0000000000002920 . Nossiter J, Sujenthiran A, Charman SC, Cathcart PJ, Aggarwal A, Payne H, et al. Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England. Br J Cancer. 2018;118:489–94. https://doi.org/10.1038/bjc.2017.454 . Lindenberg MMA, Retèl VVP, Kieffer JJM, Wijburg CC, Fossion L, van der Poel HHG, et al. Long-term functional outcomes after robot-assisted prostatectomy compared to laparoscopic prostatectomy: results from a national retrospective cluster study. Eur J Surg Oncol. 2021;47:2658–66. https://doi.org/10.1016/j.ejso.2021.06.006 . Chen XB, Li YG, Wu T, Du ZB, Tan CL, Zhang Q, et al. Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes. Front Oncol. 2023;13:1178592. https://doi.org/10.3389/fonc.2023.1178592 . Sharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy in elderly patients. World J Urol. 2022;40:2789–98. https://doi.org/10.1007/s00345-022-04171-4 . Fan S, Dai XF, Yang KL, Xiong SW, Xiong GY, Li ZH, et al. Robot-assisted pyeloplasty using a new robotic system, the KangDuo-Surgical Robot-01: a prospective, single-centre, single-arm clinical study. BJU Int. 2021;128:162–5. https://doi.org/10.1111/bju.15396 . Ando S, Sugihara T, Hinotsu S, Kishino H, Hirata D, Watanabe R, et al. Early recovery of urinary continence after robot-assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation. Int J Urol. 2024;31:492–9. https://doi.org/10.1111/iju.15388 . Ko YH, Huynh LM, See K, Lall C, Skarecky D, Ahlering TE. Impact of surgically maximized versus native membranous urethral length on 30-day and long-term pad-free continence after robot-assisted radical prostatectomy. Prostate Int. 2020;8:55–61. https://doi.org/10.1016/j.prnil.2019.12.005 . Ma JL, Xu WD, Chen R, Zhu YS, Wang Y, Cao WL, et al. Robotic-assisted versus laparoscopic radical prostatectomy for prostate cancer: the first separate systematic review and meta-analysis of randomised controlled trials and non-randomised studies. Int J Surg. 2023;109:1350–9. https://doi.org/10.1097/js9.0000000000000193 . Fan S, Zhang Z, Wang J, Xiong S, Dai X, Chen X, et al. Robot-assisted radical prostatectomy using the kangduo surgical robot-01 system: a prospective, single-center, single-arm clinical study. J Urol. 2022;208:119–27. https://doi.org/10.1097/ju.0000000000002498 . Lee J, Kim HY, Goh HJ, Heo JE, Almujalhem A, Alqahtani AA, et al. Retzius sparing robot-assisted radical prostatectomy conveys early regain of continence over conventional robot-assisted radical prostatectomy: a propensity score matched analysis of 1,863 patients. J Urol. 2020;203:137–44. https://doi.org/10.1097/ju.0000000000000461 . Umari P, Eden C, Cahill D, Rizzo M, Eden D, Sooriakumaran P. Retzius-sparing versus standard robot-assisted radical prostatectomy: a comparative prospective study of nearly 500 patients. J Urol. 2021;205:780–90. https://doi.org/10.1097/ju.0000000000001435 . Leow JJ, Heah NH, Chang SL, Chong YL, Png KS. Outcomes of robotic versus laparoscopic partial nephrectomy: an updated meta-analysis of 4,919 patients. J Urol. 2016;196:1371–7. https://doi.org/10.1016/j.juro.2016.06.011 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6839860","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":482460158,"identity":"69a7b5cb-1184-4e75-a7d0-227a38377a87","order_by":0,"name":"Dong Zhang","email":"","orcid":"","institution":"The First Affiliated Hospital of Ningbo University","correspondingAuthor":false,"prefix":"","firstName":"Dong","middleName":"","lastName":"Zhang","suffix":""},{"id":482460159,"identity":"6e20e2cb-c7a6-494e-ac57-02a75201f48b","order_by":1,"name":"Jinfeng Pan","email":"","orcid":"","institution":"The First Affiliated Hospital of Ningbo University","correspondingAuthor":false,"prefix":"","firstName":"Jinfeng","middleName":"","lastName":"Pan","suffix":""},{"id":482460160,"identity":"21a1c400-e515-4965-bf00-7f079a863365","order_by":2,"name":"Zhaoqun Guo","email":"","orcid":"","institution":"Ningbo University","correspondingAuthor":false,"prefix":"","firstName":"Zhaoqun","middleName":"","lastName":"Guo","suffix":""},{"id":482460161,"identity":"15734ce3-a6a0-4316-bbac-badf0f8e17fc","order_by":3,"name":"Zejun Yan","email":"","orcid":"","institution":"The First Affiliated Hospital of Ningbo University","correspondingAuthor":false,"prefix":"","firstName":"Zejun","middleName":"","lastName":"Yan","suffix":""},{"id":482460162,"identity":"2a9046f9-6707-49eb-899c-7ea35c60b18c","order_by":4,"name":"Xiaolong Jia","email":"","orcid":"","institution":"The First Affiliated Hospital of Ningbo University","correspondingAuthor":false,"prefix":"","firstName":"Xiaolong","middleName":"","lastName":"Jia","suffix":""},{"id":482460163,"identity":"25f44d76-9f8b-4ee1-b5f7-c6fc5c775db2","order_by":5,"name":"Junhui Jiang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYBACxmYQyXNAjo2Z/8GBDxUScvLEajHmZ+9hfDjjjIWxYQNxlh1InNlzhtmYt60ikeEAAbXM7czPHn6RucO44UbuMWneeRIJjA3MDx/dwOswNnNjGZ5nzAY38tIk526TyGNnYDM2zsHvFzNpCZ7DbAY3Eswk3m6TKGZs4GGTxq+F/RtICw9YC+8cicSGAwS18JhJfuA5LCHZc8bYkLeBOC1l0gw8hw342dsSH844JmFs2EzAL4b9x7dJ/uw5XN/GzHzgwIeaOjl59uaHj/FqaQAGNG8PshAzHuUgAEoejD9+EFA1CkbBKBgFIxsAAD4eTfGLp3mmAAAAAElFTkSuQmCC","orcid":"","institution":"The First Affiliated Hospital of Ningbo University","correspondingAuthor":true,"prefix":"","firstName":"Junhui","middleName":"","lastName":"Jiang","suffix":""}],"badges":[],"createdAt":"2025-06-07 00:23:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6839860/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6839860/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86669682,"identity":"64637db3-b5d3-4326-935a-6da747e58da0","added_by":"auto","created_at":"2025-07-14 11:24:32","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1414468,"visible":true,"origin":"","legend":"\u003cp\u003eThe KangDuo endoscopic surgical robot 01system. a. Patient cart. b. Relative location of the surgeon to the console with the KangDuo endoscopic surgical robot 01.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6839860/v1/50bf3dcd5d112593c318e1db.png"},{"id":86669681,"identity":"c7e388aa-8309-4624-977e-4605bf4cc1df","added_by":"auto","created_at":"2025-07-14 11:24:32","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":3193072,"visible":true,"origin":"","legend":"\u003cp\u003ePort placement template. a. Lower urinary tract surgery. b. Upper urinary tract surgery.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6839860/v1/02af2b2b01f76a2caff21233.png"},{"id":86670888,"identity":"496cab91-bae6-475f-88b3-db8c05bb72a0","added_by":"auto","created_at":"2025-07-14 11:32:32","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":3303232,"visible":true,"origin":"","legend":"\u003cp\u003ea. Image of the retroperitoneal mass and nonfunctioning kidney. b. Postoperative gross specimen.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6839860/v1/e7a127c3f2a6c67535c41c96.png"},{"id":87644633,"identity":"483c4f90-7dd5-43bb-aca1-282d8294c734","added_by":"auto","created_at":"2025-07-26 17:01:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":8576751,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6839860/v1/b7d5b65d-0bc5-4c1a-afb8-a6996576c078.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Robotic urologic surgery using the KangDuo surgical robot 01 system: A single-centre retrospective analysis","fulltext":[{"header":"Background","content":"\u003cp\u003eMinimally invasive surgeries, particularly laparoscopic surgeries, are increasingly being performed. Compared with open surgeries, minimally invasive surgeries result in less bleeding, less postoperative pain and faster postoperative recovery. In traditional laparoscopic surgeries, surgeons stand for a long period with their bodies and arms in uncomfortable positions, and often experience physical fatigue and joint stiffness. Advancements in medical technology have led to the advent of robotic surgical systems. Moreover, because robotic surgical systems are known to filter hand tremors and reduce surgeon fatigue, surgeries can be performed smoothly. In 2000, the world's first laparoscopic surgical robot, da Vinci, was approved for marketing. Compared with laparoscopy, the da Vinci robot provides a high-definition view of the surgical field, filters tremors, and rotates 360\u0026deg;. Therefore, it has been widely used in urological surgeries [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In recent years, an increasing number of surgical robots, such as the Versius, Senhent, and Hugo-RAS robots, have been introduced [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The KangDuo endoscopic surgical robot 01 is the first three-arm laparoscopic surgical robot with an open console approved for marketing by the National Medical Products Administration. Previous single-centre studies have shown that the KangDuo robot is safe and effective for urological surgeries [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This article mainly discusses the clinical application of the three-arm KangDuo robot in laparoscopic urological surgeries at our centre.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003ePatient selection and information\u003c/h2\u003e\u003cp\u003eThe clinical data of 32 patients who underwent laparoscopic urological surgery with the three-arm KangDuo robot between August 2023 and April 2024 were retrospectively analysed. Twenty of the patients underwent radical prostatectomy, 6 underwent partial nephrectomy, 2 underwent radical nephrectomy, 1 underwent radical cystectomy, 1 underwent pyeloplasty, 1 underwent a retroperitoneal mass resection, and 1 underwent radical ureteral resection.\u003c/p\u003e\u003cp\u003eThe inclusion criteria were as follows: (1) aged 18\u0026ndash;80 years; (2) able to tolerate laparoscopic surgery as evaluated preoperatively; and (3) signed an informed consent form specifically for the use of the KangDuo robotic system, in addition to standard surgical consent.\u003c/p\u003e\u003cp\u003eThe exclusion criteria were as follows: (1) severe cardiopulmonary dysfunction or other conditions unsuitable for laparoscopic surgery; (2) abnormal coagulation function; and (3) an inability to tolerate surgery.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSurgical methods and surgeon experience\u003c/h3\u003e\n\u003cp\u003eAll surgeries were completed by the same surgeon. The surgery was completed using the domestic KangDuo three-arm surgical robot (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ea shows the surgical platform). The chief surgeon was in front of the console and wore 3D glasses to observe the three-dimensional image on the display screen (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eb).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFor lower urinary tract surgeries such as radical prostatectomy and radical cystectomy, the general patient position and port placement are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003ea. For upper urinary tract surgeries such as partial nephrectomy and pyeloplasty, the general patient position and port placement are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eb. Finally, guided by the target area, the mechanical arm located at the bedside was guided into the surgical area. Each mechanical arm was connected to a trocar, and the surgery was completed as usual.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIf the patient's Gleason score was 6 or 7 before surgery and the PSA level was \u0026lt;\u0026thinsp;10 ng/mL, intrafascial radical prostatectomy was performed during the operation. If the tumour was highly malignant, extrafascial resection and external iliac and obturator lymph node dissection were performed.\u003c/p\u003e\n\u003ch3\u003eObservation indicators\u003c/h3\u003e\n\u003cp\u003eThe observation indicators included general information, docking time, operation time, intraoperative complications, postoperative hospital length of stay, postoperative complications, and postoperative surgical results. The operation time was defined as the time from skin incision to skin closure with sutures. Urinary incontinence was characterized by the use of no more than one pad per day.\u003c/p\u003e\n\u003ch3\u003eData statistics\u003c/h3\u003e\n\u003cp\u003eSPSS software was used for statistical analyses. Normally distributed continuous variables are presented as means\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviations. Nonnormally distributed variables are presented as medians. Categorical variables are presented as absolute numbers and percentages. Student's t test was used to compare the data. A P value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicated statistical significance.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eAll robotic surgeries were successful. No conversion to open surgery or to laparoscopy occurred. The median age of the patients was 70 (42\u0026ndash;82) years. The median docking time was 7.2 (5.8\u0026ndash;9.5) minutes. The median operation time was 132 (90\u0026ndash;450) minutes. The median intraoperative blood loss volume was 100 (20\u0026ndash;300) mL. The median postoperative hospital length of stay was 6 (3\u0026ndash;13) days. No Grade III or higher intraoperative or postoperative complications occurred. The mechanical arm operated smoothly and stably during the operation. The effects of intraoperative tissue cutting, electrocoagulation, and haemostasis were good. The relevant data of the various surgeries are summarized below (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSurgical data of the 32 enrolled patients who underwent robotic urologic surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatients (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDocking time (min)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOperation time (min)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eBlood loss (mL)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eLength of stay (days)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadical prostatectomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.2 (6.3\u0026ndash;9.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e129 (120\u0026ndash;180)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e100 (50\u0026ndash;500)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6 (3\u0026ndash;13)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial nephrectomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.3 (5.8\u0026ndash;7.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e132 (120\u0026ndash;150)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e50 (20\u0026ndash;200)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5 (3\u0026ndash;6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadical nephrectomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.9 (6.7\u0026ndash;7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e128 (90\u0026ndash;165)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e65 (50\u0026ndash;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5 (3\u0026ndash;7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadical cystectomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePyeloplasty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eretroperitoneal mass\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUreteral cancer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eRobot-assisted radical prostatectomy\u003c/h2\u003e\u003cp\u003eAll 20 surgeries were successful. The median age of the patients was 71.5 (60\u0026ndash;77) years. The preoperative PSA level ranged from 0\u0026ndash;45.03 ng/mL. Two patients had a preoperative Gleason score of 3\u0026thinsp;+\u0026thinsp;3, 6 had a score of 3\u0026thinsp;+\u0026thinsp;4, 4 had a score of 4\u0026thinsp;+\u0026thinsp;3, 4 had a score of 4\u0026thinsp;+\u0026thinsp;4, 3 had a score of 4\u0026thinsp;+\u0026thinsp;5, and 1 had a score of 5\u0026thinsp;+\u0026thinsp;4. One patient had clinical stage T3bN1M1b disease before surgery and received endocrine therapy for half a year. Two patients had T3bN0M0 disease, one of whom received endocrine therapy for half a year. The remaining patients had T2cN0M0 disease or lower. The median docking time was 7.2 (6.3\u0026ndash;9.5) minutes. The median operation time was 129 (120\u0026ndash;180) minutes. The median blood loss volume was 100 (50\u0026ndash;500) mL. The median postoperative hospital length of stay was 6 (3\u0026ndash;13) days. No postoperative urine leakage was observed. All urinary catheters were removed 2 weeks after surgery. The immediate postoperative urinary continence rate was 45%. The 3-month postoperative urinary continence rate was 90%, and the 6-month postoperative urinary continence rate was 100%. Four intrafascial surgeries were performed. The immediate postoperative urinary continence rate was 75%, and the 3-month postoperative urinary continence rate was 100%. Postoperative pathology revealed prostate adenocarcinoma. Two patients had stage T2 disease before surgery and were upgraded to pT3. Two patients (10%) had positive surgical margins.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eRobot-assisted partial nephrectomy\u003c/h3\u003e\n\u003cp\u003eAll 6 surgeries were successful. The median age of the patients was 53 (47\u0026ndash;70) years. The preoperative creatinine level was 70 (36\u0026ndash;95) \u0026micro;mol/L. The median docking time was 7.3 (5.8\u0026ndash;7.8) minutes. The median operation time was 132 (120\u0026ndash;150) minutes. The median renal warm ischaemia time was 17.5 (12\u0026ndash;24) minutes. The median blood loss volume was 50 (20\u0026ndash;200) mL. The median postoperative hospital length of stay was 5 (3\u0026ndash;6) days. The postoperative creatinine level was 69.5 (39\u0026ndash;92) \u0026micro;mol/L. Postoperative pathology revealed clear cell carcinoma in 3 patients, hamartoma in 2 patients, and chromophobe cell carcinoma in 1 patient. No signs of tumour recurrence were observed at the 3-month follow-up visit.\u003c/p\u003e\n\u003ch3\u003eRobot-assisted radical nephrectomy\u003c/h3\u003e\n\u003cp\u003eThe patients were 82 years old and 64 years old. The docking times were 7 minutes and 6.7 minutes, respectively. The operation times were 90 minutes and 165 minutes. The blood loss volumes were 50 mL and 80 mL, respectively. The postoperative hospital lengths of stay were 3 days and 7 days, respectively. Postoperative pathology revealed clear cell carcinoma in both patients. No signs of tumour recurrence were observed at the 3-month follow-up visit.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eRobot-assisted radical cystectomy\u0026thinsp;+\u0026thinsp;ileal conduit\u003c/h2\u003e\u003cp\u003eThe patient was 60 years old. The docking time was 9 minutes. The operation time was 300 minutes. The volume of intraoperative blood loss was 100 mL. The mean postoperative hospital length of stay was 7 days. Postoperative pathology revealed high-grade urothelial carcinoma (pT3N1M0).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eRobot-assisted pyeloplasty\u003c/h2\u003e\u003cp\u003eThe patient was 64 years old. The docking time was 7.7 minutes. The operation time was 120 minutes. The volume of intraoperative blood loss was 20 mL. The mean postoperative hospital length of stay was 7 days. Compared with the condition before surgery, the patient\u0026rsquo;s hydronephrosis improved after 3 months of follow-up.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eRobot-assisted retroperitoneal mass resection\u003c/h2\u003e\u003cp\u003eThe patient was 42 years old. Twenty years ago, he was admitted to the hospital due to a left renal contusion caused by a car accident. After discharge, an abdominal mass was found. At that time, puncture and drainage were performed. The drainage fluid was urine. In the past 20 years, the incidence of abdominal masses had gradually increased. Enhanced abdominal CT revealed the following findings: 1. a large space-occupying lesion with necrosis and haemorrhage in the left retroperitoneum; and 2. obvious hydronephrosis of the left kidney was observed (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003ea). This time, robot-assisted resection of the retroperitoneal mass and left nonfunctioning kidney was performed. The docking time was 7 minutes. The operation time was 450 minutes. Conversion to open surgery was not needed. The volume of intraoperative blood loss was 300 mL. The mean postoperative hospital length of stay was 10 days. Postoperative pathology of the gross specimen suggested a cystic‒solid mass (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eb). Pathology revealed an encapsulated nodule with bleeding and calcification in the left retroperitoneum. The mass size was 20*15 cm. The renal parenchyma was atrophic, and interstitial inflammatory cell infiltration was observed.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eRobot-assisted resection of ureteral cancer\u003c/h2\u003e\u003cp\u003eThe patient was 64 years old. Five years ago, radical resection of right renal pelvic cancer was performed because of the presence of a right renal pelvic tumour. The lower segment of the ureter was not resected during the operation. This time, the patient was admitted to the hospital due to haematuria for 1 day. A CTU examination revealed a space-occupying lesion at the bladder entrance of the lower segment of the right residual ureter. Therefore, robot-assisted resection of residual ureteral cancer was performed. The operation was successfully completed. The docking time was 8.3 minutes. The operation time was 180 minutes. The volume of intraoperative blood loss was 20 mL. The mean postoperative hospital length of stay was 6 days. Postoperative pathology suggested high-grade urothelial carcinoma. No signs of tumour recurrence were observed at the 6-month follow-up visit.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTechnological advances have led to major changes in the field of surgery. Laparoscopic and robotic technologies have greatly improved surgical outcomes and the patient prognosis. Laparoscopic surgery is known for its minimal invasiveness, whereas robotic technology has unique advantages in precision and flexibility. In recent years, surgeons have fervently pursued methods to improve the precision and outcomes of urological surgery. Surgical robots, such as the da Vinci robot, represent a new chapter in this field and have been widely used in urological surgeries such as radical prostatectomy and partial nephrectomy [\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. At present, many surgical robots have been successfully developed domestically and used in surgical operations owing to technological advances, and surgical robots are expected to be used more frequently in clinical practice. The KangDuo robot has an open console, which allows the surgeon to maintain a comfortable neck and shoulder posture during the operation, thereby significantly reducing the fatigue and discomfort associated with maintaining an unnatural position for prolonged periods. Moreover, multiple screens display high-resolution images, allowing precise navigation, preoperative three-dimensional reconstruction, intraoperative ultrasound, and intraoperative fluorescence guidance to improve surgical precision [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In addition, 5G and a fixed network allow patients to receive treatment from experts at national medical centres and county-level and municipal hospitals.\u003c/p\u003e\u003cp\u003eRobots are more commonly used in laparoscopic radical prostatectomy and partial nephrectomy. Tumour control, urinary continence, and preservation of sexual function are the three important indicators for evaluating radical prostatectomy. The robotic system can identify the surrounding anatomy of the prostate under high-definition 3D vision, reducing damage to normal tissues around the urethra. It can operate flexibly in a narrow space, free a urethra of sufficient length, and maximize the preservation of the neurovascular bundle. Therefore, it has a relatively good effect on the recovery of postoperative urinary continence function and erectile function [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Ma et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] conducted a meta-analysis of 46 studies. A total of 10,061 patients were included in the robot-assisted radical prostatectomy group and 6,639 patients were included in the laparoscopic radical prostatectomy group. The results showed that robot-assisted radical prostatectomy was superior to laparoscopic radical prostatectomy in terms of the overall urinary continence recovery rate and overall erectile function recovery rate. Fan et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] performed radical prostatectomy with the KangDuo surgical robot, and the 1-month postoperative urinary continence rate was 87.5%. In this study, the 2-week postoperative urinary continence rate was 45% in 20 patients, the 3-month postoperative urinary continence rate was 90%, and the 6-month postoperative urinary continence rate was 100%, suggesting satisfactory results. In terms of tumour control, among the 15 patients with stage pT2N0M0 disease at 6 weeks after surgery, 14 patients had a PSA level less than 0.02 ng/mL, and 11 patients had a PSA level of 0. Two patients had positive surgical margins, but the PSA level of these two patients was less than 0.02 ng/mL at 6 weeks after surgery. Therefore, endocrine therapy or radiotherapy was not administered. After 3 months of follow-up, the PSA level was 0. According to previous reports, the positive surgical margin rate after da Vinci-assisted radical prostatectomy is 9.1\u0026ndash;34%. Lee et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] reported that 1218 prostate cancer patients underwent robot-assisted laparoscopy. For patients with stage T2 disease, the positive surgical margin rate after surgery was 13.2%, and for patients with stage T3 disease and above, the positive surgical margin rate was 34%. Umari et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] performed robot-assisted radical prostatectomy on 483 patients with prostate cancer. The results revealed that for patients with stage T2 disease, the positive surgical margin rate was 9.1%, and for patients with stage T3 disease, the positive surgical margin rate was 27.6%. The overall positive surgical margin rate in this study was 10%, which was comparable to that of da Vinci surgery.\u003c/p\u003e\u003cp\u003eIn partial nephrectomy, due to the limited space in the retroperitoneal cavity, peritoneal rupture may occur, increasing the difficulty of the surgery. Therefore, the transperitoneal approach was used in this study, as it provides a wide space for manoeuvrability of the mechanical arm. However, postoperative ileus may occur after transperitoneal surgery. In this study, after the drainage tube was placed, the perirenal fascia was resutured to reduce the exposure of the surgical wound. After being exhausted on the first day after surgery, the patient was allowed to resume a liquid diet, albeit with a reduced volume. On the second day after surgery, the patient was allowed to resume a semiliquid diet. No signs of ileus were observed at the 3-month follow-up visit. Tumour control and the protection of renal function are important indicators for evaluating the success of partial nephrectomy. Jeffrey et al. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] conducted a meta-analysis of 25 studies with a total of 4919 people. Compared with laparoscopic surgery, robot-assisted partial nephrectomy results in a shorter warm ischaemia time, and no significant difference in the positive margin rate is observed. The reason may be that the mechanical arm of the robot surgical system can rotate 360\u0026deg; and can accurately complete fine movements such as cutting, suturing, and knotting. In this study, the surgeon blocked the main renal artery and completely resected the tumour along its edge at a distance of 0.5 cm. During suturing, the assistant used a suction device to ensure a good view of the surgical field and controlled the warm ischaemia time within 25 minutes. No significant differences in renal function were observed before and after surgery, which indicated successful tumour control and preserved renal function.\u003c/p\u003e\u003cp\u003eImprovements in clinical manifestations, the relief of hydronephrosis, and improvements in renal function are signs of successful surgery. One pyeloplasty was completed at our centre. The operation was completed smoothly and did not exceed 2 hours. No perioperative complications occurred. Notably, since the mechanical arm cannot provide direct tactile feedback, the surgeon should apply appropriate tension to the suture during the suturing process and maintain an appropriate suture spacing to avoid ureteral tearing. For this patient, a D‒J tube was placed during the operation. Three months after the operation, a re-examination revealed that the degree of hydronephrosis was lower than before, and the patient's symptoms had significantly improved. In addition, radical cystectomy and the resection of a retroperitoneal mass were successfully completed at our centre. Intraoperative bleeding was within a controllable range. The long duration of the operation may be related to the difficulty of the surgery itself. All patients were discharged within 10 days after surgery. In conclusion, the KangDuo robot can be safely and effectively applied in common urological surgeries.\u003c/p\u003e\u003cp\u003eThis study has the following limitations: (1) the small sample size and confounding factors may have affected the results; (2) the study was a single-centre retrospective study, future prospective studies should prioritize such evaluations. Additionally, (3) the follow-up time was relatively short, which was insufficient to evaluate long-term oncologic control or functional recovery. Extended follow-up studies are warranted to address these questions. Therefore, more multicentre, prospective, and larger-scale randomized trials comparing the KangDuo system with established robotic platforms are warranted to validate its advantages in terms of operative efficiency and oncological outcomes.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, according to our single-centre experience, the application of the three-arm KangDuo robot 01 system in urological surgeries is feasible, safe, and effective. However, large-sample studies with longer follow-up times, as well as multicentre randomized controlled trials, are still needed to further evaluate the effectiveness and safety of this robotic surgical system.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Ningbo Clinical Research Center for Urological Disease (No. 2019A21001) and the Ningbo Top Medical and Health Research Program (No. 2022020203).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or nonfinancial conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’ contributions\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDong Zhang, data collection and manuscript writing. Jinfeng Pan, data collection and data analysis. Zhao qun Guo, data collection. Zejun Yan, manuscript writing. Xiaolong Jia, data collection and critical revision of the manuscript. Junhui Jiang, data analysis and critical revision of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Ningbo University (No. 221RS-01). The ethics declaration is in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors affirm that the human research participants provided informed consent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to national regulations on personal data protection but are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAutorino R, Nathan S. Robotic surgery in urology: recent advances. Asian J Urol. 2023;10:385\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ajur.2023.08.005\u003c/span\u003e\u003cspan address=\"10.1016/j.ajur.2023.08.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCannoletta D, Gallioli A, Mazzone E. A global perspective on the adoption of different robotic platforms in uro-oncological surgery. Eur Urol Focus.2025. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.euf.2025.03.016\u003c/span\u003e\u003cspan address=\"10.1016/j.euf.2025.03.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eXiong SW, Fan S, Chen SB, Wang X, Han GP, Li Z, et al. Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: a single-center prospective analysis. Chin Med J. 2023;136:2960\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/cm9.0000000000002920\u003c/span\u003e\u003cspan address=\"10.1097/cm9.0000000000002920\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNossiter J, Sujenthiran A, Charman SC, Cathcart PJ, Aggarwal A, Payne H, et al. Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England. Br J Cancer. 2018;118:489\u0026ndash;94. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/bjc.2017.454\u003c/span\u003e\u003cspan address=\"10.1038/bjc.2017.454\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLindenberg MMA, Ret\u0026egrave;l VVP, Kieffer JJM, Wijburg CC, Fossion L, van der Poel HHG, et al. Long-term functional outcomes after robot-assisted prostatectomy compared to laparoscopic prostatectomy: results from a national retrospective cluster study. Eur J Surg Oncol. 2021;47:2658\u0026ndash;66. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ejso.2021.06.006\u003c/span\u003e\u003cspan address=\"10.1016/j.ejso.2021.06.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen XB, Li YG, Wu T, Du ZB, Tan CL, Zhang Q, et al. Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes. Front Oncol. 2023;13:1178592. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fonc.2023.1178592\u003c/span\u003e\u003cspan address=\"10.3389/fonc.2023.1178592\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSharma G, Shah M, Ahluwalia P, Dasgupta P, Challacombe BJ, Bhandari M, et al. Perioperative outcomes following robot-assisted partial nephrectomy in elderly patients. World J Urol. 2022;40:2789\u0026ndash;98. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00345-022-04171-4\u003c/span\u003e\u003cspan address=\"10.1007/s00345-022-04171-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFan S, Dai XF, Yang KL, Xiong SW, Xiong GY, Li ZH, et al. Robot-assisted pyeloplasty using a new robotic system, the KangDuo-Surgical Robot-01: a prospective, single-centre, single-arm clinical study. BJU Int. 2021;128:162\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/bju.15396\u003c/span\u003e\u003cspan address=\"10.1111/bju.15396\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAndo S, Sugihara T, Hinotsu S, Kishino H, Hirata D, Watanabe R, et al. Early recovery of urinary continence after robot-assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation. Int J Urol. 2024;31:492\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/iju.15388\u003c/span\u003e\u003cspan address=\"10.1111/iju.15388\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKo YH, Huynh LM, See K, Lall C, Skarecky D, Ahlering TE. Impact of surgically maximized versus native membranous urethral length on 30-day and long-term pad-free continence after robot-assisted radical prostatectomy. Prostate Int. 2020;8:55\u0026ndash;61. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.prnil.2019.12.005\u003c/span\u003e\u003cspan address=\"10.1016/j.prnil.2019.12.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMa JL, Xu WD, Chen R, Zhu YS, Wang Y, Cao WL, et al. Robotic-assisted versus laparoscopic radical prostatectomy for prostate cancer: the first separate systematic review and meta-analysis of randomised controlled trials and non-randomised studies. Int J Surg. 2023;109:1350\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/js9.0000000000000193\u003c/span\u003e\u003cspan address=\"10.1097/js9.0000000000000193\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFan S, Zhang Z, Wang J, Xiong S, Dai X, Chen X, et al. Robot-assisted radical prostatectomy using the kangduo surgical robot-01 system: a prospective, single-center, single-arm clinical study. J Urol. 2022;208:119\u0026ndash;27. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ju.0000000000002498\u003c/span\u003e\u003cspan address=\"10.1097/ju.0000000000002498\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLee J, Kim HY, Goh HJ, Heo JE, Almujalhem A, Alqahtani AA, et al. Retzius sparing robot-assisted radical prostatectomy conveys early regain of continence over conventional robot-assisted radical prostatectomy: a propensity score matched analysis of 1,863 patients. J Urol. 2020;203:137\u0026ndash;44. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ju.0000000000000461\u003c/span\u003e\u003cspan address=\"10.1097/ju.0000000000000461\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUmari P, Eden C, Cahill D, Rizzo M, Eden D, Sooriakumaran P. Retzius-sparing versus standard robot-assisted radical prostatectomy: a comparative prospective study of nearly 500 patients. J Urol. 2021;205:780\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ju.0000000000001435\u003c/span\u003e\u003cspan address=\"10.1097/ju.0000000000001435\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLeow JJ, Heah NH, Chang SL, Chong YL, Png KS. Outcomes of robotic versus laparoscopic partial nephrectomy: an updated meta-analysis of 4,919 patients. J Urol. 2016;196:1371\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.juro.2016.06.011\u003c/span\u003e\u003cspan address=\"10.1016/j.juro.2016.06.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Robotics, KangDuo surgical robot, Partial nephrectomy, Radical prostatectomy","lastPublishedDoi":"10.21203/rs.3.rs-6839860/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6839860/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eTo explore the clinical application of the three-arm KangDuo robot in urological surgeries.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThe clinical data of 32 patients who underwent robot-assisted urological surgeries performed by the same surgeon between August 2023 and April 2024 were retrospectively analysed. Twenty of the patients underwent radical prostatectomy, 6 underwent partial nephrectomy, 2 underwent radical nephrectomy, 1 underwent radical cystectomy, 1 underwent pyeloplasty, 1 underwent a retroperitoneal mass resection, and 1 underwent residual ureteral cancer resection.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAll surgeries were successful, and no Clavien\u0026ndash;Dindo grade III or higher complications occurred perioperatively. The median age of the patients was 70 (42\u0026ndash;82) years. The median docking time was 7.2 (5.8\u0026ndash;9.5) minutes. The median operation time was 132 (90\u0026ndash;450) minutes. The median intraoperative blood loss volume was 100 (20\u0026ndash;300) mL. The median postoperative hospital length of stay was 6 (3\u0026ndash;13) days.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe three-arm KangDuo robot can be safely and effectively used in urological surgeries, but large-scale multicentre studies are needed for further verification.\u003c/p\u003e","manuscriptTitle":"Robotic urologic surgery using the KangDuo surgical robot 01 system: A single-centre retrospective analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-14 11:24:28","doi":"10.21203/rs.3.rs-6839860/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c9a3ec3f-d3cc-42ca-9e47-30b72675e1de","owner":[],"postedDate":"July 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-26T16:53:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-14 11:24:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6839860","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6839860","identity":"rs-6839860","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}