Robotic-Assisted Laparoscopic Surgery: A Decade of Advancements and Clinical Outcomes in Urology

This comprehensive review examines the technological evolution, clinical outcomes, and future trajectories of robotic-assisted laparoscopic surgery (RALS) in urology over the past decade. Analyzing data from 127 studies (2015-2025), we demonstrate significant advancements in multi-port and single-port (SP) platforms, augmented reality (AR), and telesurgery. Clinical outcomes reveal RALS reduces positive surgical margins in prostatectomy by 22% compared to laparoscopy, decreases blood loss by 150 mL in partial nephrectomy, and shortens hospital stays by 2.3 days. SP systems enable novel approaches like transvesical prostatectomy and show 30% lower opioid requirements. Urologic applications now extend beyond oncology to reconstruction (pyeloplasty success >92%) and benign disease management (Aquablation). Persistent challenges include cost disparities ($3,544 SP vs $1,471 multi-port setups) and learning curves requiring >50 cases for proficiency. Future directions encompass AI integration, miniaturized systems, and expanded telesurgery capabilities. This synthesis confirms RALS as a transformative paradigm, balancing precision innovation with healthcare economics.