Artificial intelligence in robot-assisted radical prostatectomy:From technical innovation to clinical translationOA
Prostate cancer remains one of the most common malignancies in men,and robot-assisted radical prostatectomy(RARP)is widely used for localized and selected locally advanced disease.However,balancing oncological control with urinary continence,erectile function,and neurovascular preservation remains challenging.This tension between technical capability and biological uncertainty has driven interest in artificial intelligence(AI)as structured support across the RARP workflow.This review summarizes AI applications in preoperative risk stratification,three-dimensional AI–driven augmented reality(3D-AI-AR)guidance,surgical video intelligence,predictive analytics,and performance assessment,with emphasis on clinical translation rather than technical novelty.Current evidence suggests that AI can support side-specific risk assessment,intraoperative orientation,outcome prediction,and objective feedback.In the prospective randomized RIDERS trial,3D-AI-AR guidance during nerve-sparing RARP reduced residual positive surgical margins after selective excisional biopsies at preserved neurovascular bundles(22%vs.39%)and postoperative radiotherapy(18%vs.35%),and improved 12-month zero-pad continence recovery(91%vs.71%),while potency and short-term biochemical recurrence(BCR)were similar between groups.Prediction models have reported an area under the receiver operating characteristic curve(AUC)of 0.77 for side-specific extraprostatic extension and an external-validation AUC of 0.89 for early BCR.Nevertheless,the field remains limited by retrospective designs,heterogeneous endpoints,limited external validation,cross-platform generalizability,workflow integration,and regulatory uncertainty.AI in RARP should therefore be regarded as assistive rather than substitutive.Routine implementation will require prospective multicenter validation,standardized reporting,calibrated clinical endpoints,and trustworthy human-centered deployment.
Biao Ran;Shi Qiu;Mo Zhang;Zeyu Chen;Bo Chen;Jinze Li;Jingxin Bai;Jie Chen;Boshi Jian;Sihan Chen;Yin Huang;Dehong Cao;Liangren Liu;Jianbin Bi;Qiang Wei
Department of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology,The First Hospital of China Medical University,Shenyang Liaoning 110001,China Institute of Urology,China Medical University,Shenyang Liaoning 110001,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China Department of Urology,Deyang People’s Hospital/Deyang Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Deyang Sichuan 618000,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,ChinaDepartment of Urology,The First Hospital of China Medical University,Shenyang Liaoning 110001,China Institute of Urology,China Medical University,Shenyang Liaoning 110001,ChinaDepartment of Urology/Institute of Urology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China
医药卫生
Artificial intelligenceRobot‑assisted radical prostatectomyProstate cancerAugmented realitySurgical video intelligenceFunctional preservation
《Intelligent Oncology》 2026 (3)
P.54-65,12
supported by the National Natural Science Foundation of China(General Program)(Grant Nos.:82370775 and82570905)the 1.3.5 Project for Disciplines of Excellence of West China Hospital,Sichuan University(Top Talent Project)(Grant No.:ZYGD23001)the Natural Science Foundation of Sichuan Province(Grant Nos.:2026NSFSC1598 and 2026NSFSC1821)。
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