The PRISMA flow diagram shows the detailed study selection process (Supplementary Fig. 1). Our study strategy identified 5633 manuscripts overall. After intensive screening, 18 eligible papers, published between 2022 and 2025, were identified and selected, analysing data of 631 patients who underwent RAPN using novel MRS totally. Sixteen papers were reported in full-text [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30] and two were conference abstracts [31, 32]. Two studies [23, 28] analyzed differences between three robotic platforms (Da Vinci MRS, KangDuo MRS, and EGDE MRS), so both KangDuo and EDGE groups were included in our study. One study by Prata et al. [33] was not included in the analysis due to a more recent article published on the same population but was considered fundamental for trocar placement (Supplementary Table 3).

Six studies were conducted retrospectively [15, 17, 18, 20, 31, 32], twelve used a prospective design [16, 19, 21,22,23,24,25,26,27,28,29,30]. 6 of them are comparative studies between Da Vinci MRS and novel MRS [15, 19, 23, 28,29,30]. The novel MRS involved are: Hinotori in two manuscripts [15, 16], Hugo RAS in five manuscripts [17,18,19,20, 31], Toumai in three manuscripts [21, 22, 29], Dexter in one manuscript [32], KangDuo in three manuscripts [23, 28, 30], Versius in two manuscripts [24, 25], EDGE in two manuscripts [23, 28], and Carina in two manuscripts [26, 27].

Overall, 18 manuscripts focused on 631 RAPN performed using the novel MRS. As abovementioned, 6 of them were comparative studies between Da Vinci MRS and novel MRS, comparing data with 573 patients who underwent RAPN using Da Vinci MRS.

According to RoB-2, the manuscript by Li et al. [30] and by Chen et al. [29] had some concerns regarding RoB. According to ROBINS-I, three studies [15, 16, 19] were assessed to have a low RoB. Six papers [20, 21, 23,24,25, 28] were assessed to have a moderate RoB. Seven papers [17, 18, 22, 26, 27, 31, 32] were assessed to have a high RoB. Detailed results are shown in Supplementary Fig. 2 and Supplementary Fig. 3.

Analyzing demographic data from MRS arm in Table 1a, mean age is 58.4 (SD 6.5) years, mean BMI 25.2 (2.2) kg/m2, female patients are 238 (39.8%) on 15 studies [15,16,17,18,19,20,21,22,23,24,25,26, 28,29,30], mean tumor diameter is 32 (4.5) mm, mean RENAL nephrometry score is 6.7 (1.1).

Demographic data of Da Vinci arm can be found in Table 1b. In the Da Vinci arm mean age is 58.8 (11.7) years, mean BMI is 24.6 (4.1) kg/m2, female patients are 197 (34.4%) on 6 studies [15, 19, 23, 28,29,30].

In Table 2a, novel MRS arm: mean docking time is 7.4 (3.2) minutes, mean console time is 107.2 (31) minutes, mean operative time is 155.6 (32.9) minutes, mean EBL is 112.6 (63.7) mL, mean WIT is 18.2 (6.7) minutes, and mean LOS is 4.3 (2.3) days. Overall, 120 (27.2%) procedures were performed clampless on 13 studies [15, 17,18,19,20,21,22,23, 25, 29,30,31,32], and 15 (2.4%) postoperative complications CD > 2 occurred on 17 studies [15,16,17,18,19,20,21,22,23,24,25,26, 28,29,30,31,32]. Only 3 (0.6%) intraoperative conversions to open or laparoscopic surgery occurred on 13 studies [15, 16,