20.500.12556/DiRROS-30686 Robot-assisted radical prostatectomy as the institutional standard complete transition and contemporary outcomes from a high-volume European center Background: Robot-assisted radical prostatectomy (RARP) is the predominant surgical approach for localized prostate cancer in high-volume centers worldwide. However, comprehensive real-world data describing complete institutional transition from open to robotic surgery remain limited. This study evaluated perioperative and early oncological outcomes of a contemporary RARP cohort and characterized the transition from open radical prostatectomy (ORP) to RARP in a European center. Methods: We analyzed 520 consecutive patients who underwent RARP between January 2023 and December 2025. Perioperative, pathological, and biochemical outcomes were assessed. Biochemical recurrence was defined as prostate-specific antigen ≥0.2 ng/mL. Institutional data from 2011 to 2025 were reviewed to evaluate procedural trends and the transition from ORP to RARP. Surgeon-specific and institutional learning curves were analyzed using operative time and linear regression models. Results: Following the introduction of robotic surgery in 2018, annual RARP volume increased from 37 procedures to 205 in 2025. Since 2023, RARP accounted for more than 99% of all radical prostatectomies. Median operative time decreased from 185 min in 2023 to 165 min in 2025, with consistent downward trends observed across all surgeons. Linear regression confirmed progressive improvement in operative efficiency, with learning rates ranging from −0.22 to −0.92 min per case. Estimated blood loss was minimal, no patients required transfusion, and major complications occurred in four patients (0.8%). Hospital stay decreased from 2 days to predominantly 1 day. During follow-up, 36 patients developed biochemical recurrence or PSA persistence. Biochemical recurrence-free survival differed significantly according to pathological stage (log-rank p < 0.001), with 24-month estimates of 93.7%, 91.5%, and 82.1% for pT2, pT3a, and pT3b disease, respectively. Conclusions: RARP provides favorable perioperative safety, minimal morbidity, and favorable early oncological outcomes in a high-volume setting. The complete institutional transition from ORP to RARP, together with demonstrated surgeon-specific and institutional learning effects, supports the feasibility and safety of implementing RARP as the institutional standard within a structured robotic program. robot-assisted radical prostatectomy prostate cancer robotic surgery surgical outcomes minimally invasive surgery perioperative outcomes healthcare transformation robotsko asistirana radikalna prostatektomija rak prostate robotska kirurgija kirurški izidi minimalno invazivna kirurgija perioperativni izidi transformacija zdravstvenega sistema true false true Angleški jezik Slovenski jezik Neznano 2026-07-01 10:04:01 2026-07-01 10:04:01 2026-07-03 03:46:47 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 16. 6. 2026; str. 1-13 iss. 12, [article no.] 4606 Vol. 15 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 617 2077-0383 10.3390/jcm15124606 281817859 RAZ_Hawlina_Simon_2026.pdf RAZ_Hawlina_Simon_2026.pdf 1 C7F7E72D2D40F4CE02DBCD9E165116F2 c34d5c61936471d86b6195db596d44f3d423460f00b39f7b285a64765b55baf5 19966f0e-75fe-11f1-834d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=47042 https://www.mdpi.com/2077-0383/15/12/4606 1 6cf6da9d-7523-11f1-b0d9-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=46750 Univerzitetni klinični center Ljubljana 0 0 0