Background. Decision on using nerve-sparing technique during robot-assisted radical prostatectomy (RARP) involves a compromise between oncological safety and preservation of erectile function affecting patients' quality of life. One of the approaches to decreasing oncological risks of nerve-sparing technique is intraoperative histological examination of the areas of the prostate neighboring the neurovascular bundle.

Aim. To evaluate the efficacy of express intraoperative histological examination of prostate regions adjacent to neurovascular bundle (CELPM protocol) during nerve-sparing RARP.

Materials and methods. Between March 2019 and October 2025 at the S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Moscow Healthcare Department, nerve-sparing RARP with express histological examination of the lateral prostate margin was performed in 58 patients. All surgical interventions were performed using Si and Xi da Vinci models through transperitoneal access by two surgeons. Express and final histological examinations of all samples were performed at the Division of Pathological Anatomy of the Center. Presence of tumor tissue in the stained resection margin was considered a positive result of the examination.

Results. Mean time to CELPM was 35 minutes. Mean operative time was 190 min. Unilateral and bilateral preservation of the neurovascular bundle was performed in 22.4 and 77.6 % of cases, respectively. Risk of recurrence was intermediate in 17.2 % of cases and high in 72.4 %. of cases. Extraprostatic tumor extension per the final histological examination was observed in 22.4 % of patients. The CELPM protocol showed tumor tissue in the resection margin in 23 % of cases. Planned histological examination of secondarily resected neurovascular bundles confirmed tumor process in 10 of 11 cases (90.9 %). In 1 case, oncological process in secondarily resected tissue was not confirmed. Tumor tissue in the resection margin during planned histological examination of the gross specimen (prostate, seminal vesicles, parts of the distal urethra/bladder neck) was found in 9 (15.5 %) of 58 cases. It is important to note that in all cases it was found outside the scope of previous express histological examination.

Conclusion. The use of express histological examination technique (CELPM protocol) during nerve-sparing RARP allows to intraoperatively evaluate the status of resection margin which allows to resect the neurovascular bundles with tumor tissue during a single surgery decreasing the risk of early biochemical recurrence. This technique might extend the indications for nerve-sparing RARP, especially in patients with intermediate and high risk.

Background. Decision on using nerve-sparing technique during robot-assisted radical prostatectomy (RARP) involves a compromise between oncological safety and preservation of erectile function affecting patients' quality of life. One of the approaches to decreasing oncological risks of nerve-sparing technique is intraoperative histological examination of prostate regions adjacent to neurovascular bundle.

Aim. To evaluate the efficacy of express intraoperative histological examination of prostate regions adjacent to neurovascular bundle (CELPM protocol) during nerve-sparing RARP.

Materials and methods. Between March 2019 and October 2025 at the S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Moscow Healthcare Department, nerve-sparing RARP with express histological examination of the lateral prostate margin was performed in 58 patients. All surgical interventions were performed using Si and Xi da Vinci models through transperitoneal access by two surgeons. Express and final histological examinations of all samples were performed at the Division of Pathological Anatomy of the Center. Presence of tumor tissue in the stained resection margin was considered a positive result of the examination.

Results. Mean time to CELPM was 35 min. Mean operative time was 190 min. Unilateral and bilateral preservation of the neurovascular bundle was performed in 22.4 and 77.6 % of cases, respectively. Risk of recurrence was intermediate in 17.2 % of cases and high in 72.4 %. of cases. Extraprostatic tumor extension per the final histological examination was observed in 22.4 % of patients. The CELPM protocol showed tumor tissue in the resection margin in 23 % of cases. Planned histological examination of secondarily resected neurovascular bundles confirmed tumor process in 10 of 11 cases (90.9 %). In 1 case, oncological process in secondarily resected tissue was not confirmed. Tumor tissue in the resection margin during planned histological examination of the gross specimen (prostate, seminal vesicles, parts of the distal urethra/bladder neck) was found in 9 (15.5 %) of 58 cases. It is important to note that in all cases it was found outside the scope of previous express histological examination.

Conclusion. The use of express histological examination technique (CELPM protocol) during nerve-sparing RARP allows to intraoperatively evaluate the status of resection margin which allows to resect the neurovascular bundles with tumor tissue during a single surgery decreasing the risk of early biochemical recurrence. This technique might extend the indications for nerve-sparing RARP, especially in patients with intermediate and high risk.

Introduction. Robot-assisted radical cystectomy (RARC) is increasingly adopted as a minimally invasive alternative to open surgery for muscle-invasive bladder cancer. The optimal urinary diversion technique remains a subject of debate.

The aim of the study is to compare perioperative outcomes, complication rates and quality of life after RARC with Bricker ileal conduit versus Studer orthotopic neobladder.

Materials and methods. A retrospective review of 93 patients who underwent RARC with Bricker ileal conduit (n = 74) or Studer orthotopic neobladder (n = 19) at the A.S. Loginov Moscow Clinical Research Center in 2018-2024 was performed. Operative time, blood loss, in-hospital days, Clavien-Dindo complications and EORTC QLQ-BLM30 quality of life scores 6 and 12 months after the surgery were assessed.

Results. Mean operative time for Studer orthotopic neobladder (462.28 ± 75.66 min) was longer than for Bricker ileal conduit (361.96 ± 46.84 min, p <0.05). The volume of blood loss was also higher for orthotopic diversion (292.22 ± 76.22 mL versus 216.64 ± 104.62 mL, p = 0.001). Complication rates per the Clavien-Dindo classification were similar (p >0.05). Physical, emotional and social well-being scores favored the Studer group 6 months after the intervention but equalized by 12 months (p >0.05).

Conclusion. Studer neobladder is characterized by longer operative time and higher blood loss compared to Bricker technique with similar complication rate. Orthotopic diversion provides superior early postoperative quality of life, but the differences disappear after 12 months.

Introduction. Pancreatoduodenectomy remains one of the most challenging procedures in abdominal surgery due to its technical complexity and high complication rate. Robotic pancreatoduodenectomy (RPD) is a minimally invasive approach that provides enhanced precision and visualization. This study describes the surgical technique and evaluates outcomes of RPD performed at the S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center.

The aim of the study is to evaluate safety of RPD in treatment of tumors of the head of the pancreas, major duodenal papilla, and distal part of the common bile duct, and to provide detailed description of the technique.

Materials and methods. A retrospective analysis of 178 RPDs performed between January 2013 and October 2025 at the S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center of the Moscow Healthcare Department was conducted. All procedures were performed using the da Vinci Si/Xi robotic surgical systems. Complications were graded according to the Clavien—Dindo classification, and pancreas-specific complications were assessed using the International Study Group on Pancreatic Surgery (ISGPS) definitions.

Results. Mean operative time was 357 ± 7.1 min; mean blood loss was 174 ± 55 mL; conversion rate was 2.8 % (n = 5). Major complications (Clavien—Dindo grades III-V) occurred in 19.7 % (n = 35) of patients. Postoperative pancreatic fistula developed in 66.8 % of patients, postpancreatectomy hemorrhage in 7.3 %, and gastroparesis in 6.2 %. Mortality was 2.8 % (n = 5).

Conclusion. RPD is feasible and safe in experienced hands, with an acceptable complication profile comparable to open and laparoscopic techniques. It is associated with reduced blood loss and has potential to improve oncological outcomes. Further randomized studies are needed to confirm its long-term benefits.

The aim of the study is to analyze current evidence on the use of fluorescence-guided navigation with indocyanine green (ICG) during robot-assisted radical prostatectomy (RARP) and to assess its impact on surgical accuracy and patient safety.

Materials and methods. A literature review was conducted using the PubMed, Scopus, and Web of Science databases for the period 2010–2025. The search included the following key terms: indocyanine green, ICG, radical prostatectomy, robot-assisted prostatectomy, lymphadenectomy, fluorescence-guided surgery. Systematic reviews, prospective, and retrospective studies evaluating the application of ICG in RARP were analyzed.

Results. The use of ICG during RARP improves intraoperative visualization of lymph nodes, neurovascular bundles, and the dorsal venous complex, thereby enhancing the accuracy of lymphadenectomy and reducing the risk of injury to critical anatomical structures. Most studies demonstrate that ICG application shortens operative time, decreases blood loss, and increases the rate of nerve-sparing procedures without raising the incidence of positive surgical margins. However, standardization of the ICG dosage and administration protocol remains lacking, and further large-scale randomized trials are required to confirm its efficacy and reproducibility.

Conclusion. Fluorescence-guided surgery using indocyanine green represents a promising approach for intraoperative visualization during RARP, improving the precision and safety of surgical interventions. Further research is needed to optimize administration protocols and validate the method through multicenter clinical trials with high levels of evidence.

For centuries, mankind has sought to facilitate physical labor, increase productivity, and improve production tools. The process was not quick and easy: from stone scrapers to a wheel, from the simplest mechanisms to spaceships - a distance of millennia. And with each new discovery, new horizons appear, which until recently seemed like a figment of the imagination of science fiction writers.