










































This is an open access article under the terms of a license that permits non-commercial use, provided the original work is properly cited.  
© 2021 The Authors. Société Internationale d'Urologie Journal, published by the Société Internationale d'Urologie, Canada.

Key Words Competing Interests Article Information

Robot-assisted surgery, laparoscopy, robotics, 
urology

 None declared. Received on October 6, 2020 
Accepted on June 1, 2021

Soc Int Urol J.2021;2(5):300–310

DOI: 10.48083/EWWQ2677

300 SIUJ  •  Volume 2, Number 5  •  September 2021 SIUJ.ORG

REVIEW

A Scoping Review of Emerging and  
Established Surgical Robotic Platforms  
With Applications in Urologic Surgery
Braden Millan,1 Shavy Nagpal,1 Maylynn Ding,1 Jason Y. Lee,2 Anil Kapoor1

1 Urologic Cancer Centre for Research and Innovation (UCCRI), McMaster University, Hamilton, Canada  
2 Department of Surgery, Division of Urology, University of Toronto, Canada

Abstract

Objectives Since the introduction of the first master–slave robotic platform for surgical procedures, there have 
been ongoing modifications and development of new platforms, but there is still a paucity of commercially available 
systems. Our study aims to identify all master–slave robotic surgical platforms currently commercially available or in 
development around the world with applications in urologic surgery.

Methods A scoping literature search was performed using PRISMA methodology to identify all relevant 
publications in English in PubMed, PubMed Central, and Embase, with additional information being obtained from 
official company websites.

Results Ten robotic platforms with either proven or potential application in urologic surgery were identified: the 
da Vinci surgical system (Intuitive), Senhance surgical system (Transentrix), Versius Surgical (CMR Ltd), Enos 
surgical system (Titan Medical), Revo –I (Meere Company), MiroSurge (DLR), Avatera System (Avatera Medical), 
Hugo Surgical Robot (Medtronic), Ottava (J&J, Ethicon, Areus), and Hinotori (Medicaroid Corporation).

Conclusions This review highlights the distinct features of emerging master–slave robotic platforms with 
applications in urologic surgery. Research and development are now focused on finding wider applications, improving 
outcomes, increasing availability, and reducing cost. Additional research is required comparing newly developed 
master–slave robotic platforms with those already well established.

http://SIUJ.org
mailto:akapoor%40mcmaster.ca?subject=SIUJ


Introduction

The f ield of urolog y has played a major role in 
t he adva ncement of su rg ic a l robot ic s, d at i ng 
back to the MONA robot, the prototy pe of the 
modern day da  Vinci surgical robot[1]. The most 
advanced surgical robotic platforms currently are 
the ‘‘master–slave systems’’ in which the surgeon 
controls robotic arms remotely from a console.  
In a dry laboratory setting, Choussein and colleagues 
were able to demonstrate that robot-assisted laparoscopy 
nearly eliminated operative handedness, which persists 
in conventional laparoscopy[2]. Robotic platforms 
can be categorized by some of their key features, 
and there are many similarities amongst them. One 
major distinction is the open versus the closed robotic 
platform console. In an open console, there is no ability 
for the operator to fix his or her head in position; 
instead, the head can be moved freely during the 
procedure. These alterations in the field of view from 
the display during an operation can result in errors 
and decreased efficiency[3]. A development in newer 
generations of robotic platforms is the addition of haptic 
feedback from the robot for the operating physician.  
Abiri and colleagues tested a multi-modal system for 
haptic force feedback in robotic surgery that results in 
nearly a 50% force reduction in comparison to a system 
with no haptic feedback[4].

Laparoendoscopic single-site surgery (LESS) is 
another feature of surgical robotic platforms that 
is an advancement from original laparoscopy. One 
disadvantage of LESS is the challenge of instruments 
interfering with one another, although early success has 
been reported[5–7]. No head-to-head comparison of any 
robotic platforms from different companies exists in the 
urologic literature. This paper provides a scoping review 
on established and emerging master–slave robotic 
platforms in urologic surgery.

Methods
In the absence of a clear population, intervention, 
comparison, and outcome research question, we elected 
to perform a systematic scoping review of the currently 
available literature on this topic[8]. The goal of this 
article is not to compare surgical or oncologic outcomes 
of procedures performed with the different robotic 

platforms, but to highlight the emerging technologies 
in robotic platforms. Three databases were searched 
for articles published in English. PubMed and PubMed 
Central (n = 3644) were searched using the following 
terms: "robotic surgica l procedures," “robotics,” 
"urology," "urology department, hospital," “urologic 
surgical procedures,” “urologic surgical procedures, 
male.” Embase (n  =  3252) was searched using the 
following terms: “robot,” “robotics,” “robotic surgical 
procedures,” “robot assisted surgery,” “urology,” “child 
urology,” “urologic surgery.” Additional records were 
identified through screening the citations of selected 
texts (n  = 20; Figure 1). Additional information was 
obtained by searching through google.com (Google Inc, 
Mountain View, United States) and official company 
websites (n  =  9). All case reports, case series, cohort 
studies, and randomized controlled trials written in 
English were included. Articles were excluded if they 
were abstracts, editorials, expert opinions, or review 
articles, if they did not report the surgical platform 
used, or if the platform has been discontinued. Preferred 
reporting items for systematic reviews and meta-
analyses (PRISMA) guidelines were used to ensure 
reproducibility of our scoping review[9].

Results
After initial screening of titles, 57 articles underwent 
final review, and 41 articles were included in the final 
paper (Figure 1)[10]. A total of 10 master–slave surgical 
robots were identified through our scoping systematic 
review. For each surgical platform we sought to provide 
information regarding the current company with 
proprietary rights to the device, whether or not it had 
regulatory approval, the main features of the robotic 
platform, and a review of any pre-clinical or clinical 
data (Table 1). A summary of the major features of each 
system is shown in Table 2.

da Vinci Surgical System 
The da  Vinci surgica l system is a master–slave 
laparoscopic robotic platform, designed and owned 
by Intuitive Surgica l (Sunny va le, United States) 
(Figure 2). It has played a crucial role in enhancing 
minimally invasive surgery and was Food and Drug 
Administration (FDA) approved in the year 1998, 
originally for laparoscopic cholecystectomies, and 
received the Conformitè Europëenne (CE) mark in 2017. 
One of its early competitors, Zeus (Computer Motion), 
was discontinued following the company’s merger with 
Intuitive Surgical in 2003. Iterations of the da  Vinci 
have been in use for over 2 decades, and its applications 
include general, cardiac, colorectal, otolaryngology, 
neurosurgery, thoracic, g ynecologic and urologic 
surgery. Its features include a 3-dimensional (3-D) high-
definition (HD) camera with a binocular view, and 

301SIUJ.ORG SIUJ  •  Volume 2, Number 5  •  September 2021

A Scoping Review of Emerging and Established Surgical Robotic Platforms With Applications in Urologic Surgery

Abbreviations 
DOF degrees of freedom
HD high definition
LESS laparoendoscopic single-site surgery
MIS minimally invasive surgery
N/A not available



Records identified from:
 Databases (n = 6896)
 PubMed/Central (n = 3644)
 Embase (n = 3252)

Records removed before 
screening:
 Duplicate records (n = 874)
 Editorials (n = 189)
 Reply by authors (n = 200)
 This month in... (n = 16)

Reports sought for retrieval
(n = 64)

Reports assessed for eligibility 
(n = 57)

Records screened 
(n = 5617)

Records excluded 
(n = 5553)

Identification of studies via databases and registers

Id
en

tif
ic

at
io

n
Sc

re
en

in
g

In
cl

ud
ed

Reports excluded:
 Did not report robotic platform 
 used (n = 4)
 Language other than 
 English (n = 1)
 Not master–slave robotic 
 platform (n =1)
 Did not meet inclusion/exclusion 
 criteria (n = 10)

Studies included in review
(n = 41)

Records screened 
(n = 5617)

FIGURE 1. 

PRISMA flow diagram[10] 

302 SIUJ  •  Volume 2, Number 5  •  September 2021 SIUJ.ORG

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TABLE 1.

Emerging and currently available master–slave robotic platforms with applications in urologic surgery 

Company

Intuitive Surgical TransEnterix CMR Surgical Titan Medical Meere Company

Robotic 
Platform

Da Vinci 
(Si, X, Xi, and SP)

Senhance Versius Enos** Revo - i

Headquarters United States United States United Kingdom Canada Republic of Korea 

Approach Laparoscopic, LESS Laparoscopic Laparoscopic LESS Laparaoscopic

Advertised 
Application

Urology, Gynecology, 
General Surgery, & 

Otolaryngology

Urology, 
Gynecology, General, 

Colorectal & 
Limited Cardiothoracic 

Surgery

Urology, 
Gynecology, 
Colorectal & 

Upper GI

Urology,  
General Surgery

Urology,
 Gynecology & 

General Surgery

Status 
Commercially 

available
Commercially 

available 
Commercially 

available
Under development Commercially available

Regulatory 
Approval

FDA approved (1998)
European CE Mark 

(2017)

FDA approved (2017)
European CE Mark 

(2016)

European CE  
Mark (2019)  

TGA approval
 (2020)

Not approved
Korean Ministry for 

Drug and Food Safety 
(2019)

Maximum 
number of 
Robotic Arms

4 4 5 1 4

Degrees of 
Freedom

7 6 7 6 12

Console Seated, Closed Seated, Open
Seated/standing, 
Open (3D glasses)

Seated, Open Seated, Open

Camera HD – 3D HD – 3D HD – 3D HD – 3D HD – 3D

Haptic 
Feedback

No Yes Yes No Yes

LESS: laparoendoscopic single site surgery; GI: gastrointestinal; N/A :not available; HD-3D: high definition three dimensional; FDA: US Food and 
Drug Administration; TGA: Therapeutic Goods Administration (Australia);  CE: Conformitè Europëenne; * previously the Verb and Auris robotic 
platform; **Rebranded from the single port orifice robotic technology (SPORT) surgical system

continued on page 303

303SIUJ.ORG SIUJ  •  Volume 2, Number 5  •  September 2021

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TABLE 1.

Emerging and currently available master–slave robotic platforms with applications in urologic surgery, Cont’d 

Company

Robotics and 
Mechatronics Center 
at German Aerospace 

Center (DLR)

Avatera  
Medical

Medtronic
Johnson & 
Johnson/ 

Ethicon/ Verily

Medicaroid Corporation 
(Kawasaki/ Sysmex)

Robotic 
Platform

DLR MiroSurg Avatera Hugo Ottava* Hinotori

Headquarters Germany Germany Ireland United States Japan

Approach Laparoscopic Laparoscopic Laparoscopic Laparoscopic Laparoscopic

Advertised 
Application

Urology, General &  
Thoracic surgery

Urology &  
gynecology

Urology, Baratric, 
Colorectal & 

Thoracic Surgery
N/A Urology

Status Under development 
Under  

development
Under 

development
Under 

development
Under development

Regulatory 
Approval

Not approved
European CE  
Mark (2019)

Not approved Not approved
Japanese Ministry of Health, 

Labor & Welfare (2020) 

Maximum 
number of 
Robotic Arms

5 4 4 6 4

Degrees of  
Freedom

3 7 7 N/A 8

Console 
Seated, Open 
 (3D glasses)

Seated,  
Closed

Seated,  
Semi-Open 
(3D glasses)

N/A
Seated, Semi-Open  
(polarized glasses)

Camera HD – 3D HD – 3D HD – 3D N/A HD - 3D

Haptic 
Feedback

Yes Yes N/A N/A N/A

LESS: laparoendoscopic single site surgery; GI: gastrointestinal; N/A :not available; HD-3D: high definition three dimensional; FDA: US Food and 
Drug Administration; TGA: Therapeutic Goods Administration (Australia);  CE: Conformitè Europëenne; * previously the Verb and Auris robotic 
platform; **Rebranded from the single port orifice robotic technology (SPORT) surgical system

304 SIUJ  •  Volume 2, Number 5  •  September 2021 SIUJ.ORG

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up to 3 instrument arms, which articulate at the wrist 
of the instrument with 7 degrees of freedom (DOF). 
There several available series, including the da Vinci S, 
Si, X, Xi, and SP (single port), with the newest versions 
having haptic feedback for the operator. Although 
modifications are aimed at improvement in currently 
available technology, reports suggest that changing 
from one model to another still poses some challenges 
for the surgeons[11]. However, certain models may be 

better suited for certain procedures, for example, the 
Xi resulted in a 48 minute shorter operative time for 
nephroureterectomies[12]. Intuitive has also made 
advances in the field of LESS, where in addition to the 
SP platform, they have developed software to allow 
for same-sided hand–eye control of the instruments 
that enables the surgeon’s right hand to control the 
screen right instrument even though the instrument is 
in the left robotic arm and vice versa[13]. LESS using 
the da Vinci SP system allows a smaller incision with 
superior cosmesis and non-inferior oncologic and 
surgical outcomes, although there appears to be a great 
learning curve[6,7,14–17]. Additionally, side docking 
for urologic procedures has been made possible with 
the da  Vinci S and Si systems, allowing better access 
to the perineum and the urethra throughout the 
procedure[18]. Successful use of the da Vinci has been 
reported for surgeries including radical prostatectomy, 
simple enucleation of the prostate, radical cystectomy 
w it h int ra or ex t ra-cor porea l i lea l conduit or 
neobladder, radical and simple nephrectomy, live 
donor nephrectomy, pyeloplasty, adrenalectomy, sural 
nerve grafting, vaso-vasostomy, ureteral reimplant, 
and renal transplantation[14,19–25]. In addition to 
surgery on adults, da Vinci has also been successfully 
used in pediatrics using 5mm instruments as well as a 
LESS approach with no conversion to open procedure 
and with high success rates[26,27]. There are few direct 
comparisons of the costs of robot-assisted laparoscopy 
in urologic surgery, although previous reports dating 
back nearly a decade suggested use of the da  Vinci 
surgical platform was more expensive secondary to 
capital cost, maintenance of the robot, and limited life 
of the instruments[28]. Intuitive Surgical has grown its 
da Vinci Surgical System installed base to 6142 systems 
as of March 31, 2021, an increase of 8% compared with 
5669 as of the end of the first quarter of 2020, continuing 
its near monopoly on the field of master–slave surgical 
platforms globally.

TABLE 2. 

Summary of major features of identified master–slave 
robotic platforms 

Feature

Degrees of freedom

6 Enos

7
Da Vinci, Senhance, Avatera, Hugo, 
Versius, MiroSurge

8 Hinotori

12 Revo-i

Approach

Laparoscopic
Senhance, Avatera, Hugo, Revo - I,  
Versius, MiroSurge, Hinotori

LESS Enos

Both Da vinci

Console

Closed Davinci, Avatera, Revo-i

Open Senhance, Enos, MicroSurge

Semi-open Hugo, Hinotori

Semi-closed Medicaroid

Seated/standing-open Versius

Haptic Feedback

Yes
Da Vinci, Senhance, Avatera, Revo-I, 
Versius, MiroSurge

No Enos

N/A Hugo, Hinotori

LESS: laparoendoscopic single site surgery; N/A: not available; Ottava 
excluded as details of system unknown

FIGURE 2. 

da Vinci Surgical System  
(Credit: Intuitive Surgical) 

305SIUJ.ORG SIUJ  •  Volume 2, Number 5  •  September 2021

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Senhance Surgical System
The Senhance surgical system is a master–slave robotic 
platform designed by TransEnterix (Figure 3). It was 
renamed from the Alf – X in 2016, developed by 
SOFAR SpA (Milan, Italy), which was used to perform 
its first clinical cases in 2015[29,30]. This system and 
the da Vinci by Intuitive are the 2 master–slave robotic 
platforms that have both a CE mark (2014) and FDA 
approval (2017)[31]. Its features include a seated-open 
concept control centre with haptic handles, a 2-D or 
3-D HD monitor, depending on surgeon preference, 
an infrared eye-tracking system, a keyboard and touch 
pad, a single pedal, up to 4 detached and independent 
robotic arms, and reusable 5mm endoscopic instru-
ments[32,33]. The major benefit of the open structure 
is reduced cost, as it allows for use of conventional 
laparoscopic equipment and operating t heaters. 
Criticisms include a larger size, restricting space in the 
operating room, and longer time to dock the robotic 
arms[30]. Plans for the Senhance Surgical System 
include a “machine vision system,” a form of augmented 
intelligence whereby the system moves the camera on 
the basis of prior procedures and the movements of 
the surgeon’s instruments. Initial report of the first 40 
extra-peritoneal radical prostatectomies performed 
by Kaštelan et al. showed higher than expected length 
of hospital stay and indwelling catheter time; however, 
this was thought to be related to the learning curve of 
using a new platform[34]. Samalavicius and colleagues 
performed 31 radical prostatectomies using Senhance, 
with few complications and no conversion to open 
procedures[35]. A subsequent case series reported 
decreases in positive surgical margin rate and lower rates 
of postoperative incontinence in patients undergoing 
radical prostatectomy, and expanded the application 
of the Senhance robotic platform to adrenalectomies, 
nephrectomy, kidney cyst fenestration, and pyeloplasty 
with success[36]. The aforementioned developments 
and clinical data showing the success of the Senhance 
platform will make it a strong competitor in the field of 
master–slave surgical robots.

Versius Surgical Robotic System 
The Versius system is a master–slave surgical platform 
developed by Cambridge Medical Robotics Limited 
(CMR Ltd) Surgical in the United Kingdom (Figure 4). 
It received the CE Mark in 2019 and Therapeutic 
Goods Administration (Australia) approval in 2020. 
The platform is ergonomic, with an open console that 
enables both sitting and standing for the operator, 
with HD-3D visual aid. The surgeon can use up to 5 
lightweight robotic arms, each as a solitary robotic 
unit for greater freedom of port placement. V-wrist 
technology allows 360-degree wrist motion, 7 DOF, 
with haptic feedback[37]. Although not performed 
with the final product, pre-clinical trials using Versius 
were completed, with a total of 24 surgeries performed 
(radical nephrectomy, radical prostatectomy, and pelvic 
lymph node dissection), with no device or non-device 
intraoperative complications[38]. Human clinical trials 
using the platform have been limited to gynecologic and 
general surgery procedures[39].

Enos Surgical System 
The Enos surgical system, rebranded in 2020 from the 
single-port orifice robotic technology (SPORT) surgical 
system is master–slave robotic platform created by the 
Canadian company, Titan Medical (Toronto, Canada). 
Enos does not have FDA approval or CE mark to date. 
The surgeon workstation is a seated-open design, 
with 3D-HD visualization. It has a single-arm mobile 
patient cart to allow for LESS, and a multi-articulating 
endoscope and instruments that provide 6 DOF. In 2018, 
Seeliger and colleagues showed promising feasibility 
and operator improvement with the SPORT platform by 

FIGURE 3. 

Senhance Surgical System  
(Credit: Asensus Surgical, TransEnterix) 

FIGURE 4. 

Versius Surgical Robotic System  
(Credit: CMR Surgical) 

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completing 12 minimally invasive procedures in porcine 
and human cadaveric pre-clinical trial procedures[5]. 
There are currently no pre-clinical or clinical data 
specifically on the Enos platform since it was rebranded.

Revo-I Model MSR-5000
Meere Company Incorporated, a Korean company, 
began development on the Revo-I Model MSR-5000, 
a master–slave robotic surgical platform, in 2006. 
The Revo-I Model MSR-5000 received approval for 
commercial use from the Korean government in August 
2017, but it has not received FDA or CE Mark to date. 
The Revo-I Model MSR-5000 (Figure 5) consists of a 
seated-closed surgeon control console, a 4-arm robotic 
operation cart, a 3D-HD vision cart, and reusable 
endoscopic instruments[40,41]. Previous models of the 
robotic platform had a seated-open surgical console[42]. 
The Revo-I Model MSR-5000 robotic instruments also 
offer the greatest f lexibility with 12 DOF compared 
with the 7 DOF built into its contemporaries. Chang 
and colleagues successfully completed 17 Retzius-
sparing robotic prostatectomy using the Revo-I Model 
MSR-5000 with no conversion to open or laparoscopic 
procedures or systems failures. One major limitation 
of this study, however, was that no pelvic lymph node 
dissections were performed for fear of intraoperative 
pelvic vessel injury[41]. Despite these successes, there 
has not been widespread use of the Revo-I Model MSR-
5000 outside Korea.

MiroSurge 
The DLR (Deutsches Zentrum für Luft- und Raumfahrt 
e.V) telesurgery MiroSurge is a master–slave robotic 
platform made by German Aerospace Center. It 
currently does not have any regulatory body approval. 
The DLR MiroSurge (Figure 6) is a modular system that 
combines several robotic components, including 3 robot 
arms (DLR MIRO) and at least 2 instruments (DLR 
MICA). It offers a seated-open console with a 3-D HD 
video display, with instruments with 3 DOF and haptic 
feedback. One of the arms guides the laparoscopic view 
while the video screen updates the status of currently 
used instruments and prevents collision of instruments 
via force feedback[43]. No current pre-clinical or clinical 
data are available; the last publication was in 2011.

FIGURE 6. 

MiroSurge  
(Credit: MiroSurge, German Aerospace Center)

FIGURE 5. 

Revo-I Model MSR-5000  
(Credit: Revo-i, robotic surgical system (meerecompany) 

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Avatera System 
The Avatera system (Figure 7) is a master–slave robotic 
platform which has been in development since 2011 as a 
joint venture between Avateramedical (Jena, Germany) 
and Force Dimension (Nyon, Switzerland). It received 
European CE Mark approval in 2019. It offers a seated-
closed console, with 4 robotic arms mounted on a single 
cart, forceps-like handles with haptic feedback, single-
use 5mm instruments with 7 DOF, and an HD-3D 
camera. Unique features include the absence of external 
fans, which decreases the noise level, and a space-saving 
compact design. No clinical data on the use of the 
Avatera System have been published to date.

Hugo RAS System
The Hugo RAS system is a master–slave robotic platform 
created by Medtronic, following the acquisition of 
German-based robotic system MiroSurge as part of the 
acquisition of Covidien in 2014. It does not currently 
have regulatory approval in Europe. The surgeon 
console employs a seated, semi-open design, requiring 
3-D glasses with HD visualization. Each robotic arm 
is attached to an individualized cart, allowing robotic 
arms to be split up and used for different procedures, 
each with 7 DOF. Currently, no pre-clinical or clinical 
data are available.

Ottava
Ottava, previously the Verb master–slave robotic 
platform, is in development, and is a joint venture by 
Ethicon, Johnson & Johnson (J & J), and Verily (a life 
sciences research organization within Google, Inc).  
In addition, in 2019, J & J acquired Auris Health who had 
developed the MONARCH platform for endoscopy. The 
platform does not have any regulatory body approval. 
Initial reports suggest that there may be 6 robotic arms 
directly attached to the operating table, but there is 
no credible information about the robotic platform 
currently available and no identified pre-clinical or 
clinical data on the Ottava platform.

Hinotori
The Hinotori master–slave surgical platform was 
developed through a joint venture begun in 2013 
between 2 Japanese companies, Kawasaki Heav y 
industries, Ltd and Sysmex Company. The Hinotori 
surgical system, which received Japanese regulatory 
approval in August 2020, is advertised as an easy 
docking system, with 4 robotic arms attached to the 
cart, and instruments with 8 DOF. The surgeon wears 
polarized glasses, using a semi-open console with a 
microscope-like ocular lens. Although a simulation 
system is in development for use on this platform, no 
pre-clinical or clinical data have been published to date.

Conclusions
We provide a scoping review of identified master–
slave robotic surgical platforms with applications in 
urology. Despite increasing use of these platforms in 
surgery, there is still a paucity of published literature 
comparing different robotic platforms, many of 
which are still awaiting regulatory approval. Cost 
comparisons are currently not possible as many of these 
emerging platforms are not yet commercially available. 
Further research with direct comparisons of robotic 
platforms will be necessary to assess clinical outcomes, 
surgeon preference, and economic and environmental 
sustainability. To this point, the Intuitive Surgical 
da  Vinci series has dominated the field, but this will 
likely change as other systems are approved.

FIGURE 7. 

Avatera System  
(Credit: Avateramedical)  

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References

1. Challacombe BJ, Khan MS, Murphy D, Dasgupta P. The history of 
robotics in urology. World J Urol.2006;24(2):120–127. doi: 10.1007/
s00345-006-0067-1

2. Choussein S, Srouji SS, Farland LV, Wietsma A, Missmer SA, Hollis 
M, et al. Robotic assistance confers ambidexterity to laparoscopic 
surgeons. J Minim Invasive Gynecol.2018;25(1):76–83. doi: 10.1016/j.
jmig.2017.07.010.

3. Atug F, Castle EP, Woods M, Davis R, Thomas R. Robotics in urologic 
surgery: an evolving new technology. Int J Urol.2006;13(7):857–863. 
doi: 10.1111/j.1442-2042.2006.01428.x

4. Abiri A, Pensa J, Tao A, Ma J, Juo YY, Askari SJ, et al. Multi-modal 
haptic feedback for grip force reduction in robotic surgery. Sci 
Rep.2019;9(1):5016. doi: 10.1038/s41598-019-40821-1.

5. Seeliger B, Diana M, Ruurda JP, Konstantinidis KM, Marescaux 
J, Swanstrom LL. Enabling single-site laparoscopy: the SPORT 
plat form. Surg Endosc. 2019;33(11):3696 –3703. doi: 10.1007/
s00464-018-06658-x

6. Gaboardi F, Pini G, Suardi N, Smelzo S, Passaretti G, Rosso M, et al. 
Robotic laparoendoscopic single-site (r-LESS) radical prostatectomy: 
IDEAL phase 1. Eur Urol.(Suppl) 2016;15 (3):eV12.

7. Billah MS, Stifelman M, Munver R, Tsui J, Lovallo G, Ahmed M. 
Single port robotic assisted reconstructive urologic surgery-with the 
da Vinci SP surgical system. Transl Androl Urol.2020;9(2):870–878. 
doi: 10.21037/tau.2020.01.06

8. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris 
E. Systematic review or scoping review? Guidance for authors 
when choosing between a systematic or scoping review approach. 
BMC Med Res Methodol.2018;18(1):143.https://doi.org/10.1186/
s12874-018-0611-x

9. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred 
reporting items for systematic reviews and meta-analyses: the 
PRISMA statement. Int J Surg.2010;8(5):336–341. doi: 10.1016/j.
ijsu.2010.02.007

10. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow 
CD, et al. The PRISMA 2020 statement: an updated guideline for 
reporting systematic reviews. Int J Surg.2021;88:105906. https://doi.
org/10.1016/j.ijsu.2021.105906

11. Goonewardene SS, Cahill D. The da Vinci Xi and robotic radical 
prostatectomy-an evolution in learning and technique. J Robot 
Surg.2017;11(2):111–113. doi: 10.1007/s11701-016-0620-x

12. Patel MN, Hemal AK. Does advancing technology improve outcomes? 
Comparison of the da Vinci Standard/S/Si to the Xi Robotic Platforms 
during robotic nephroureterectomy. J Endourol.2018;32(2):133–138. 
doi: 10.1089/end.2017.0477

13. Autorino R, Kaouk JH, Stolzenburg JU, Gill IS, Mottrie A, Tewari A, et 
al. Current status and future directions of robotic single-site surgery: 
a systematic review. Eur Urol.2013;63(2):266–280. doi: 10.1016/j.
eururo.2012.08.028

14. Won Lee J, Arkoncel FR, Rha KH, Choi KH, Yu HS, Chae Y, et al. 
Urologic robot-assisted laparoendoscopic single-site surgery using 
a homemade single-port device: a single-center experience of 68 
cases. J Endourol.2011;25(9):1481–1485. doi: 10.1089/end.2010.0656

15. Gavazzi A, Belba A, Dasgupta P. Robotic single-port transumbilical 
radical prostatectomy: our first experience using the gel-port system. 
BJU Int.2012;(3):130.

16. Kim KH, Song W, Yoon H, Lee DH. Single-port robot-assisted radical 
prostatectomy with the da Vinci SP system: a single surgeon's 
experience. Investig Clin Urol.2020;61(2):173–179. doi: 10.4111/
icu.2020.61.2.173

17. Kaouk J, Aminsharifi A, Sawczyn G, Kim S, Wilson CA, Garisto J, et al. 
Single-port robotic urological surgery using purpose-built single-port 
surgical system: single-institutional experience with the first 100 
cases. Urology.2020;140:77–84. doi: 10.1016/j.urology.2019.11.086

18. Chan ES, Yee CH, Lo K L, Chan CK, Hou SM, Ng CF. Side-
docking technique for robot-assisted urologic pelvic surger y. 
Urology.2013;82(6):1300–1303. doi: 10.1016/j.urology.2013.08.017

19. Chan SY, Hou SM, Wong WS, Ng CF. Robotic urological surgery: 
prospects for Hong Kong. Surg Pract.2007;11(4):154–158.

20. Park SY, Jeong W, Choi YD, Chung BH, Hong SJ, Rha KH. Yonsei 
experience in robotic urologic surger y - Application in various 
urological procedures. Yonsei Med J.2008;49(6):897–900. doi: 
10.3349/ymj.2008.49.6.897

21. Fareed K, Zaytoun OM, Autorino R, White WM, Crouzet S, Yakoubi R, 
et al. Robotic single port suprapubic transvesical enucleation of the 
prostate (R-STEP): initial experience. BJU Int.2012;110(5):732–737. 
doi: 10.1111/j.1464-410X.2012.10954.x

22. Yuh B, Yu X, Raytis J, Lew M, Fong Y, Lau C. Use of a mobile tower-
based robot - the initial Xi robot experience in surgical oncology. J Surg 
Oncol.2016;113(1):5–7. https://doi.org/10.1002/jso.24094

23. Osmonov D, Prell F, Kalz A, Junemann KP. VS-1-9 Da Vinci robot-assisted 
vasovasostomy and vasoepididymostomy. J Sex Med.2020;17(6 Suppl 
2):S149.

24. Mah L, Noel O, Rothschild J, Dall'Era M, Canvasser N. Right robotic 
intracorporeal ileal ureter with single-position port placement using 
da Vinci Xi. J Urol.2019;201(4 Suppl 1):e401.

25. Garisto J, Bertolo R, Kaouk J. Transperineal Approach for intracorporeal 
ileal conduit urinary diversion using a purpose-built single-port robotic 
system: step-by-step. Urology.2018;122:179–184. doi: 10.1016/j.
urology.2018.08.019

26. Paradise HJ, Huang GO, Elizondo Saenz RA, Baek M, Koh CJ. Robot-
assisted laparoscopic pyeloplasty in infants using 5-mm instruments.  
J Pediatr Urol.2017 Apr;13(2):221–222.doi: 10.1016/j.jpurol.2016.12.011

27. Kang SK, Jang WS, Kim SW, Kim SH, Han SW, Lee YS. Robot-
assisted laparoscopic single-port pyeloplasty using the da Vinci 
SP® system: initial experience with a pediatric patient. J Pediatr 
Urol.2019;15(5):576–577. doi: 10.1016/j.jpurol.2019.08.003

309SIUJ.ORG SIUJ  •  Volume 2, Number 5  •  September 2021

A Scoping Review of Emerging and Established Surgical Robotic Platforms With Applications in Urologic Surgery



28. Ahmed K, Ibrahim A, Wang TT, Khan N, Challacombe B, Khan MS, 
et al. Assessing the cost effectiveness of robotics in urological 
surgery - a systematic review. BJU Int.2012;110(10):1544–1556. doi: 
10.1111/j.1464-410X.2012.11015.x

29. Bozzini G, Gidaro S, Taverna G. Robot-assisted laparoscopic 
par tial nephrectomy with the ALF-X robot on pig models. Eur 
Urol.2016;69(2):376–377. doi: 10.1016/j.eururo.2015.08.031

30. Falavolti C, Gidaro S, Ruiz E, Altobelli E, Stark M, Ravasio G, et al. 
Experimental nephrectomies using a novel telesurgical system: (The 
Telelap ALF-X)-a pilot study. Surg Technol Int.2014;25:37–41.

31. Brodie A, Vasdev N. The future of robotic surgery. Ann R Coll Surg 
Engl.2018;100(Suppl 7):4–13. doi: 10.1308/rcsann.supp2.4

32. deBeche-Adams T, Eubanks WS, de la Fuente SG. Early experience 
with the Senhance(R)-laparoscopic/robotic platform in the US. J Robot 
Surg.2019;13(2):357–359. doi: 10.1007/s11701-018-0893-3

33. Kaštelan Ž, Knežević  N, Hudolin T, Kuliš T, Penezić  L, Goluža E, et al. 
Extraperitoneal radical prostatectomy with the Senhance Surgical 
System robotic platform. Croat Med J.2019;60(6):556–559. doi: 
10.3325/cmj.2019.60.556

34. Kastelan Z, Hudolin T, Kulis T, Penezic L, Gidaro S, Bakula M, et al. 
Extraperitoneal radical prostatectomy with the Senhance Robotic 
Platform: first 40 cases. Eur Urol.2020;78(6):932–934. doi: 10.1016/j.
eururo.2020.07.012

35. Samalavicius NE, Janusonis V, Siaulys R, Jasenas M, Deduchovas 
O, Venckus R, et al. Robotic surger y using Senhance® robotic 
platform: single center experience with first 100 cases. J Robot 
Surg.2020;14(2):371–376. doi: 10.1007/s11701-019-01000-6

36. Kastelan Z, Hudolin T, Kulis T, Knezevic N, Penezic L, Maric M, et al. 
Upper urinary tract surgery and radical prostatectomy with Senhance® 
robotic system: single center experience-first 100 cases. Int J Med 
Robot.2021 Aug;17(4):e2269. doi: 10.1002/rcs.2269

37. Haig F, Medeiros ACB, Chitty K, Slack M. Usability assessment of 
Versius, a new robot-assisted surgical device for use in minimal access 
surgery. BMJ Surg Interv Health Technol.2020;2:e000028. doi:10.1136/ 
bmjsit-2019-000028

38. Thomas BC, Slack M, Hussain M, Barber N, Pradhan A, Dinneen E, 
et al. Preclinical evaluation of the Versius Surgical System, a new 
robot-assisted surgical device for use in minimal access renal and 
prostate surgery. Eur Urol Focus.2021;7(2):444–452. doi: 10.1016/j.
euf.2020.01.011

39. Kelkar D, Borse MA, Godbole GP, Kurlekar U, Slack M. Interim safety 
analysis of the first-in-human clinical trial of the Versius surgical 
system, a new robot-assisted device for use in minimal access surgery. 
Surg Endosc.2020. doi: 10.1007/s00464-020-08014-4

40. Kim DK, Park DW, Rha KH. Robot-assisted partial nephrectomy with 
the REVO-I Robot Platform in porcine models. Eur Urol.2016;69(3):541–
542. doi: 10.1016/j.eururo.2015.11.024

41. Chang KD, Abdel Raheem A, Choi YD, Chung BH, Rha KH. Retzius-
sparing robot-assisted radical prostatectomy using the Revo-i robotic 
surgical system: surgical technique and results of the first human 
trial. BJU Int.2018;122(3):441–448. https://doi.org/10.1111/bju.14245

42. Abdel Raheem A, Troya IS, Kim DK, Kim SH, Won PD, Joon PS, et al. 
Robot-assisted Fallopian tube transection and anastomosis using the 
new REVO-I robotic surgical system: feasibility in a chronic porcine 
model. BJU Int.2016;118(4):604–609. doi: 10.1111/bju.13517

43. Hagn U, Konietschke R, Tobergte A, Nickl M, Jorg S, Kubler B, et 
al. DLR MiroSurge: a versatile system for research in endoscopic 
telesurgery. Int J Comput Assist Radiol Surg.2010;5(2):183–193. doi: 
10.1007/s11548-009-0372-4

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