Perioperative efficacy and safety of the MP1000 robotic surgical system versus the da Vinci robotic surgical system in urologic surgery: a systematic review and meta-analysis.

Robot-assisted surgery (RAS) has now become widely adopted in the clinical field, and there is one platform, the da Vinci system, which has captured the lion's share of the world market. The size, acquisition, and upkeep expenses of this incumbent device, however, have limited its use in resource-constrained areas. The MP1000 robotic surgical system is an independently developed surgical robot that has been introduced into the clinical setting in recent years. This study was designed to evaluate and compare the perioperative outcomes of the MP1000 with the da Vinci platform across major urologic oncologic procedures. A systematic search of PubMed, EMBASE, Web of Science, and Cochrane Library was performed to identify clinical studies directly comparing the MP1000-assisted platform with the da Vinci system in urologic surgery. Outcomes examined included total operative time, estimated blood loss, docking time, console time, positive surgical margins (PSM), and overall complications. Procedure-specific subgroup analyses were conducted for robot-assisted radical prostatectomy (RARP), robot-assisted partial nephrectomy (RAPN), and robot-assisted radical cystectomy (RARC). Six articles provided seven datasets comprising 510 patients (203 MP1000, 307 da Vinci). Procedure-specific analyses revealed differential findings. For RAR P, MP1000 was associated with significantly longer operative time (MD 20.12 min, 95% CI 2.43-37. 81, p < 0.05) and higher complication rates (OR 3.65, 95% CI 1.08-12.31, p < 0.05), but no significant differences in blood loss or PSM. For RAPN, no significant differences were observed for operative time, blood loss, complications, or PSM; however, patients in the MP1000 arm had lower RENAL nephrometry scores (less complex tumors), representing selection bias favoring the novel system. For RARC, limited data (single study) showed higher blood loss with MP1000 attributable to a single case with severe adhesions. Across procedures, docking time (WMD = 1. 58 min, 95% CI: 1.29 to 1.87, p < 0.05) and console time (WMD = 20. 44 min, 95% CI: 8.57 to 32.31, p < 0.05) were significantly longer with MP1000. The absence of PSM events in RAPN and RARC cohorts reflected small sample sizes rather than definitive oncologic equivalence. Preliminary findings suggest that the MP1000 platform demonstrates perioperative outcomes that did not differ significantly from the da Vinci system for several endpoints in select urologic oncologic procedures. Due to the relative inexperience of the operative team with this new technology, however, longer docking and console times were needed with the MP1000. Importantly, the absence of statistically significant differences should not be interpreted as evidence of equivalence or noninferiority. Large-scale multicenter randomized controlled trials-adequately powered and conducted after overcoming the learning curve-are required to validate these preliminary findings and provide evidence-based support for expanding surgical options in clinical practice.