The convergence of artificial intelligence and robotic surgery is redefining the management of genitourinary cancers by enhancing diagnostic accuracy, surgical precision, and training efficiency. This narrative review explores recent advancements in artificial intelligence applications across the cancer care continuum, with a focus on prostate, kidney, and bladder malignancies. Artificial intelligence tools, particularly those based on machine learning and deep learning, have demonstrated strong performance in analyzing imaging data, segmenting tumors, predicting pathological features, and supporting clinical decision-making. Intraoperatively, artificial intelligence enables skill assessment, personalized feedback, and real-time navigation by processing data from surgical videos and robotic system sensors. Augmented reality and intraoperative modeling further enhance visualization and margin control during complex procedures. The review also discusses emerging technologies such as single-port robotic platforms, which offer advantages in confined anatomical spaces and support less invasive approaches. Additionally, the growing field of telesurgery is addressed, highlighting its feasibility for complex urologic operations across vast distances. While many of these innovations are still in early stages of clinical validation, their integration into practice has the potential to improve oncologic and functional outcomes, expand access to expert care, and foster the development of next-generation surgical strategies in urologic oncology.

Purpose: To evaluate the feasibility and intraoperative technical parameters of the new robot-assisted surgical system Avatera by performing bilateral nephrectomy in a live porcine model. Materials and Methods: Six pigs underwent bilateral robot-assisted radical nephrectomy using the Avatera robotic system (RS). The operations were performed by experienced open (Group 1) and laparoscopic (Group 2) surgeons. The operating time, docking time, set-up time, and console time were evaluated. Data regarding intraoperative complications (major or not), injury of adjacent organs, and technical difficulties during the operation were also recorded. Results: Robot-assisted bilateral nephrectomy was completed effectively in all sample pigs. The docking time and set-up time were similar among the two groups, whereas the console time and operating time were significantly longer for the open surgeon group. Two intraoperative minor complications occurred in the open surgeon's group. An inadvertent damage of the renal vein occurred in two cases and the bleeding was controlled effectively. Other than the initial two cases, the estimated blood loss was <50 mL in both groups. Injury of the adjacent organs was not noticed. Conclusions: The study demonstrated that radical nephrectomy using the Avatera robotic surgical system is technically feasible, safe, and valid in pigs. Our results warrant the application of the Avatera RS in other urologic procedures, collecting data for further clinical trials.

Objective: To investigate the efficiency of three advanced lithotripters during the treatment of artificial stones (hard and soft) in an experimental in vitro and in vivo setting. Materials and Methods: An experimental configuration was created to treat artificial stones, made from BegoStone Plus in a weight ratio of 15:3 or 15:6 powder to water, replicating hard and soft urinary stones, respectively. Experimental data of three lithotripters, the Lithoclast Master, the Lithoclast Trilogy, and the ShockPulse-SE, were assessed. Experiments aimed at comparing the stone clearance times (SCTs) of the devices as well as different probe diameters, probe disposability, and hardness of the stones. The in vivo experiment was performed in a porcine model after the approval from the State Services. Before in vivo lithotripsy, stones had been placed through percutaneous access established by using the Bull's eye technique. The SCT between the Lithoclast Trilogy and the ShockPulse-SE was compared. Results: All the devices were statistically more efficient in the treatment of soft stones in both in vitro ( p < 0.001) and in vivo settings ( p < 0.008). The use of larger-diameter probes resulted in shorter SCT ( p < 0.007). The disposable probes of the ShockPulse-SE showed higher performance than the multiple-use probes ( p < 0.05). In the direct comparison between the devices, the Lithoclast Trilogy was found to be the fastest during all the in vitro ( p < 0.001) and in vivo ( p < 0.008) trials. Conclusion: Modern dual - energy lithotripters proved to possess high performance in the treatment of stones. Faster SCTs were observed by using the larger-diameter and disposable probes. The Lithoclast Trilogy was superior in terms of SCT over all the experimental settings compared with other lithotripters.