Abstract
Background
In the last two decades, several Da Vinci robotic platforms have been released. The new generation DaVinci-5 robot (DV5) promises hardware and software improvements with the potential for enhanced operative performance. The study aimed to compare the intraoperative performances and short-term perioperative outcomes between the DV5 and DaVinci-Xi robotic platforms in patients undergoing robotic-assisted radical prostatectomy (RARP).
Methods
We conducted a single-center retrospective cohort study from April to May 2024, during a unique 4-week period when both the Da Vinci 5 (DV5) and Da Vinci Xi (DV-Xi) platforms were available. A total of 103 patients who underwent robotic-assisted radical prostatectomy with the DV5 were retrospectively compared to 101 patients operated on with the DV-Xi during the same time frame. The primary endpoint was the comparison of intraoperative performance metrics between groups, including operative time, estimated blood loss, and intraoperative complications.
Results
The DV5 had shorter median console time (80 min, IQR [80–90] vs 90 min, IQR [80–90], median difference = 10 min, p < 0.001) and shorter median total operative time (96 min, IQR [90–103] vs 100 min, IQR [98–105], median difference = 4 min, p < 0.001). Neither group had any device malfunctions, intraoperative complications, or blood transfusions. We could not find the difference in hospital length-of-stay, postoperative complication rate, and surgical margin status. This study was done at a high-volume prostate cancer referral centre, which may limit the study findings’ generalizability.
Conclusion
This is the first study comparing outcomes of the DV5 and DVXi robotic platforms in patients undergoing RARP. The use of the DV5 robot was associated with modest gains in some perioperative outcomes, but these values were not clinically significant in our routine. Due to the short-term follow-up, we are still evaluating the long-term impacts of this new platform on these patient’s outcomes.
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Data availability
The authors confirm that the data supporting the findings of this study are available within the article. Raw data that support the findings are available from the corresponding author upon reasonable request.
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SKR contributed to study design, data acquisition, statistical analysis, drafting of the manuscript, and critical revision for important intellectual content. MCM participated in study conception and design, data interpretation, and critical revision of the manuscript. SS was involved in data acquisition and drafting of the manuscript. AG was involved in data acquisition and drafting of the manuscript. YO contributed to drafting and reviewing the manuscript and interpretation of data. RS participated in drafting and reviewing the manuscript. TR contributed to manuscript drafting and administrative support. MS performed statistical analysis and contributed to interpretation of the data. VP supervised the project and critically revised the manuscript for important intellectual content.
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The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Adventhealth (protocol number: 237998).
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Reddy, S.K., Covas Moschovas, M., Saikali, S. et al. Perioperative outcomes comparing the DaVinci 5 with DaVinci Xi in patients undergoing robotic-assisted radical prostatectomy. Prostate Cancer Prostatic Dis (2025). https://doi.org/10.1038/s41391-025-01025-z
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DOI: https://doi.org/10.1038/s41391-025-01025-z
