Initial Experience of Robot-Assisted Nephrectomy and Nephroureterectomy Using the Novel Saroa Surgical System.

Introduction: Robot-assisted surgery is increasingly utilized in urology, providing enhanced precision and potentially improving patient outcomes. The Saroa surgical system is a novel robotic platform featuring integrated haptic feedback and compatibility with standard laparoscopic instruments. This study reports the first clinical application of Saroa in robot-assisted radical nephrectomy (RARN) and nephroureterectomy (RANU).

Methods: A single-center, retrospective analysis was conducted on 11 patients who underwent RARN or RANU using Saroa between January 2024 and March 2025. Perioperative outcomes, complications, grasping force data, and Likert scale evaluations from surgeons and assistants were analyzed.

Results: All procedures were completed without conversion or major complications. No transfusions or Clavien-Dindo grade ≥ 3 complications occurred. Haptic feedback was associated with reduced grasping force (mean force: 2.94 N with feedback off vs. 0.49 N at 2.0× setting). Surgeons rated Saroa higher for haptic naturalness and grasp control, while overall satisfaction was greater with the da Vinci system. Assistants reported significantly greater technical engagement with Saroa (p = 0.042), reflecting enhanced educational value.

Conclusions: RARN and RANU using the Saroa system appear safe and feasible, even in early clinical use. The system's compact design, tactile feedback, and cost-effectiveness suggest potential for broader adoption and training utility. Further prospective studies are warranted to confirm its clinical and educational benefits.