Initial Experience in Urological Surgery with a Novel Robotic Technology: Magnetic-Assisted Robotic Surgery in Urology

Abstract

Introduction and objective: Magnetic Assisted Robotic Surgery (MARS) platform, developed by Levita Magnetics (California, USA), has been developed to maximize the patient benefits of minimally invasive surgery while enhancing surgeon control and visualization. The objective of this study was to evaluate the safety and efficacy of the MARS platform in laparoscopic renal and adrenal surgery for the first time. Methods: A prospective, single-arm, open-label, ethics committee-approved study was performed. Clinical Trials Identifier: NCT05353777. Fifteen cases of patients with renal or adrenal pathology, who were submitted to laparoscopic surgery between April and June 2022 were included. All patients were followed up to 30 days postoperatively. Preoperative, intraoperative, and postoperative data was recorded. Polynomial regression was used to determine the learning curve for docking time. Results: Ten females and five males were intervened; average age 55 years-old, average BMI 29 cm/m2. No cases required conversion to open surgery and all patients were discharged on the first or second postoperative day. No complications or re-admissions were reported within the first 30 days. All oncological cases had negative margins. Learning curve was achieved by the 4th case, diminishing docking time from 5.22 (2.6-11.5; SD 2.9) to 2.68 minutes (2.1-3.8; SD 0.67) (p=0.002). The learning curve was fitted to a cubic regression and obtained a R2=0.714. Conclusion: This is the first clinical study that demonstrates the safety and versatility of the MARS Platform in urological surgeries. The robot was especially useful for tissue retraction, avoiding additional incisions and obviating the need for a surgical assistant, while increasing surgeon control and visualization. The learning curve was rapid, achieving a short docking time after the fourth case. Further studies are required to assess its applicability in other surgical areas of this promising new technology.