Introducing the Toumai™ system for robot-assisted radical prostatectomy: a prospective feasibility and safety study in a tertiary care center

Background: The Toumai™ robotic system (MicroPort® MedBot™) is a multiport platform with CE marking for endoscopic procedures in several surgical specialties. To date, clinical experience with robot-assisted radical prostatectomy (RARP) remains limited to a small number of reported cases, with no large or comparative series available. Transitioning to a new robotic platform presents regulatory, logistical, and financial challenges. Further studies are required to evaluate its safety, efficacy, and surgical performance. We aimed to evaluate the feasibility and safety of RARP with the second-generation Toumai™ (MT1000) and describe its key features for centers considering this technology. Materials and methods: A prospective case series of RARP in patients with localized prostate cancer was performed using the Toumai™ MT1000 platform. The primary objective was to evaluate the feasibility and safety of the novel robotic system. The secondary objective was to characterize perioperative variables. Results: Fifty patients were included in the final analysis. All surgeries were completed without conversion or intraoperative complications. One patient experienced a postoperative non-urological complication requiring reoperation, and another developed acute urinary retention. The median age was 65 years (interquartile range [IQR]: 8.5), body mass index was 27.1 kg/m 2 (IQR: 5.1), and 96% were ASA I–II. Median docking time was 7.5 minutes (IQR: 7), console time 165 minutes (IQR: 50), and total OT 190 minutes (IQR: 65). Median estimated blood loss was 200 mL (IQR: 237), length of hospital stay 2 days (IQR: 1), and catheter duration 7 days (IQR: 1). Seventy percent were pT2, and 30% pT3, with an 18% positive margin rate. Minor issues included rebooting the patient cart in 6% of cases and replacing scissors in 4% of procedures. We analyzed our data by tertiles to assess the learning curve and found no significant changes over time, except for console time, which increased (median of 180, 190, and 220 minutes), and the PSM, which decreased (25%, 20%, and 13.3%). Conclusions: This study presents an initial, non-comparative, single-center experience with the Toumai™ robotic system for RARP, demonstrating its feasibility and safety in a limited cohort. Additionally, it provides valuable insights to assist medical centers and surgeons interested in adopting this technology.