Early matched comparison of a novel modular carina robotic platform and the da vinci system for robot-assisted radical prostatectomy.

This study reports the first clinical comparison of the novel modular Carina robotic platform with the established da Vinci system for robot-assisted radical prostatectomy (RARP), including 6-month outcomes. This single-center study included a prospective cohort of 32 patients undergoing Carina RARP and a retrospective cohort of 105 patients treated with da Vinci RARP. Pre-, intra-, and postoperative data were analyzed. Groups were matched 1:2 using propensity scores based on preoperative characteristics. All patients underwent 6-month follow-up assessing feasibility, safety, oncological outcomes, and urinary continence. Following matching, 32 Carina patients were compared with 64 da Vinci patients. Baseline characteristics were largely well balanced after matching. Total operative time was modestly longer in the Carina group than in the da Vinci group (median 138 vs. 130 min), whereas console time (91 vs. 85 min) and docking time (5 min for both) were comparable between systems. Operative time decreased as platform-specific experience accumulated in later Carina cases. At 6 weeks, the satisfactory biochemical response rate (PSA < 0.1 ng/mL) was identical between groups (90.6%). Urinary continence rates at 1 week, 3 months, and 6 months were 34.4%, 81.3%, and 90.6% for Carina versus 31.3%, 76.6%, and 87.5% for da Vinci, with no significant differences. The Carina system appears safe and feasible for RARP, with early oncological and continence outcomes similar to those observed with the da Vinci system in this pilot matched cohort.