Abstract
<title>Abstract</title> <p>Purpose Robot-assisted radical prostatectomy (RARP) is a standard treatment for localized prostate cancer (PCa). As new, lower-cost robotic platforms reach Latin America, comparative evidence remains scarce. We compared complications, and short-term oncological and functional outcomes between the da Vinci and the new Toumai platforms in RARP. Materials and methods Single-center, prospective, non-randomized study of patients older than 40 years with localized PCa undergoing RARP between March 2025 and March 2026, allocated 3:1 (da Vinci vs Toumai) according to operating-room and platform availability. Salvage RARP was excluded. Perioperative variables, Clavien-Dindo complications, pathological outcomes, positive surgical margins (PSM), undetectable PSA (< 0.1 ng/mL) and continence (pads/day) at one and three months were analyzed. Results Two hundred patients were analyzed (150 da Vinci vs 50 Toumai) with comparable baseline characteristics. Operative (220.2 vs 196.5 min) and console time (198.2 vs 170.5 min) were longer with Toumai (p = 0.001), which underwent more extended pelvic lymphadenectomies (24% vs 4.7%; p = 0.001). Hospital stay (1.6 days; p = 0.902), catheter duration (10.7 days; p = 0.689), overall complications (22% vs 12%; p = 0.132), PSM (26% vs 24.7%; p = 1.0) and undetectable PSA (96% vs 94%; p = 0.716) were similar. Continence (no pads) was 84% vs 69.3% at one month (p = 0.066) and 88% vs 86.7% at three months. Conclusions In a high-volume center, the da Vinci and Toumai platforms showed equivalent short-term oncological, functional, and complication outcomes.</p>