Technical advancements in robot-assisted radical prostatectomy: systematic review and bibliometric analysis

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not applicable — no clinical effect sizes reported; descriptive bibliometric metrics only

• Primary Outcome: Bibliometric mapping of 578 RARP publications (2005–2026): exponential publication growth with inflection point ~2015–2016 and accelerated momentum post-2020

• Nnt Or Sensitivity: Not applicable — no clinical outcome synthesis; thematic clusters identified include nerve-sparing techniques, continence preservation, single-port surgery, augmented reality navigation, NeuroSAFE protocol, and deep learning outcome prediction models

• Confidence Interval: Not reported

Clinical Application

Findings are relevant for identifying research priorities, training program development, and technology adoption planning. The identification of geographic disparities supports advocacy for equitable access to robotic surgery. Emerging technologies identified (NeuroSAFE, augmented reality, single-port RARP) require independent clinical evaluation before adoption. In Australia, RARP is performed at major public and private hospitals, with robotic surgery access concentrated in metropolitan centres. The TGA has approved da Vinci robotic systems for use, and Medicare Benefits Schedule (MBS) items exist for radical prostatectomy. However, access disparities between metropolitan and regional/rural Australia mirror the geographic inequities highlighted in this study. The RACGP and Urological Society of Australia and New Zealand (USANZ) guidelines support referral for RARP in eligible patients with localised prostate cancer, but the emerging technologies discussed (augmented reality, NeuroSAFE, single-port systems) are not yet standard of care in Australian practice and are not separately funded under the MBS. This bibliometric study does not alter current Australian clinical guidelines but supports the case for investment in robotic surgery research infrastructure and equitable geographic access. Urological surgeons, surgical oncologists, and health system planners involved in RARP program development; not directly applicable to individual patient management decisions

Abstract

Robot-assisted radical prostatectomy has transformed the surgical management of localized prostate cancer, yet its research landscape remains incompletely mapped. We conducted a systematic review and bibliometric analysis of 578 articles and conference papers from Scopus and Web of Science (2005-2026), following PRISMA guidelines, and analyzed publication trends, geographic and institutional distribution, author networks, journal output, keyword co-occurrence, and thematic evolution. The results reveal exponential growth in research, with an inflection around 2015-2016 and accelerated momentum after 2020, reflecting the widespread adoption and maturation of robotic programs. The United States leads in publication volume, followed by Italy and the rapidly growing contribution of China, while The University of Turin (Italy) emerges as the most productive institution due to its pioneering Retzius-sparing approach; the Journal of Robotic Surgery remains the leading publication venue. Thematic analysis demonstrates a progression from early feasibility studies to the standardization of nerve-sparing and continence-preserving techniques, advancing toward single-port surgery, augmented reality navigation, and AI-assisted intraoperative decision-making. Emerging technologies such as augmented reality, the NeuroSAFE protocol, and deep learning models for outcome prediction are particularly transformative, and geographic disparities are highlighted as critical priorities for future research.

References

1. 1.Kalam, A., Zuo, G., & Sabah, F. (2026). Technical advancements in robot-assisted radical prostatectomy: systematic review and bibliometric analysis. Journal of Robotic Surgery. https://doi.org/10.3389/fpubh.2025.1595159