Prospective Comparison of Two Robotic Platforms for the Performance of Radical Prostatectomy: Versius vs. DaVinci

Background/Objectives: To compare the perioperative, oncological and functional outcomes of the Versius® and DaVinci® systems as used for performing robot-assisted radical prostatectomy (RARP) in patients with localized prostate cancer. Methods: Prospective observational comparative study on 278 patients subjected to RARP between March 2023-September 2025. 169 procedures were performed with the Versius® system and 109 with the DaVinci® system. An analysis was performed of a series of demographic, perioperative, pathological and functional variables. Quantitative variables were compared using either Student’s t or the Mann-Whitney Test, while categorical variables were analyzed with the chi-squared test or Fisher’s Exact Test. Results: Both groups exhibited comparable baseline characteristics. No statistically significant differences were observed with respect to the amount of pelvic lymph nodes dissected, intraoperative or postoperative complications, transfusion requirements, length of hospital stay or postoperative PSA levels. DaVinci® was shown to be associated with higher rates of neurovascular bundle preservation (48.6% vs. 17.4%; p< 0.001) and the resection of a higher number of positive lymph nodes. Patients operated with the DaVinci® system were more likely to have pN1 disease (20% vs. 4.9%; p=0.014). No statistically significant differences were observed with respect to positive surgical margins, pT stage or the ISUP grade of the specimen. Urinary incontinence was more prevalent in the Versius® group at 3 and 6 months’ follow-up (p=0.003 y p=0.034, respectively), without significant differences at 12 months. Conclusions: Both Versius® and DaVinci® were shown to be safe and effective platforms for the performance of RARP, with comparable short-term perioperative and oncological outcomes.