Robotics in Urology: No More Shadows?

Round 1

Reviewer 1 Report

The aim of the study is describing the state-of-the-art of robotic surgery in each urologic procedure, showing its applications and limits.

The manuscript is not so innovative itself but it’s clear, comprehensive and presented in a well-structured manner.

The paragraph about robotic-assisted radical cystectomy (RARC) should be expanded with the inclusion of current and valid studies and reviews, already present in the literature, which can make the advantages of the robot-assisted technique more fully understood.

The reference paragraph could be a limit because most part of citation is older than 5 years; this could lead to conflicts with the purpose of the article and with the future objectives of the same.

This review, despite the limitations already mentioned, could be a good starting point for further investigations and subsequent studies on what are still today the limits of robotics, both in oncology and in non-oncology procedures.

Author Response

1. The paragraph about robotic-assisted radical cystectomy (RARC) should be expanded with the inclusion of current and valid studies and reviews, already present in the literature, which can make the advantages of the robot-assisted technique more fully understood.

Response 1 see changes in red in the attached text

2. The reference paragraph could be a limit because most part of citation is older than 5 years; this could lead to conflicts with the purpose of the article and with the future objectives of the same.

Response 2: Some new articles have been added to the review. However, articles older than 5 years have been introduced and preserved in the text in order to illustrate the evolution of robotic surgery over time.  

Author Response File: Author Response.docx

Reviewer 2 Report

Firstly, I would like to congratulate the authors for a well-constructed review. Being a robotic surgeon, I have faced the debate (robotic vs laparoscopic vs open) many times and have highlighted the benefits of the robotic approach. I always say "its not just about smaller incisions but it's what you can do inside with a robot matters". 

The present study has merit and will be of great interest to our readers. Please find my comments below:

Abstract and Introduction: well-written. No changes are required.

RARP

-What is meant by 2Oberlin in line no 49 of page no 2? Please correct

-Please expand the abbreviation BCR at its first usage in line no 72 on page no 2.

RARN

-Please also write a paragraph on the robotic management of the pediatric renal tumors

(https://onlinelibrary.wiley.com/doi/full/10.1002/pbc.27867)

-In my opinion, another section needs to be added regarding bladder augmentation and appendicovesicostomy. The robotic approach has a major role in bladder augmentation. Please highlight the role of robotic approach in both adults and children.

(https://pubmed.ncbi.nlm.nih.gov/25455178/; https://www.frontiersin.org/articles/10.3389/fped.2019.00001/full; https://link.springer.com/article/10.1007/s11884-016-0370-7)

-In the section "The impalpable factors", please elaborate on ergonomics.  (https://www.liebertpub.com/doi/abs/10.1089/lap.2021.0471)

-Conclusions: well-written. No changes are needed.

Author Response

Abstract and Introduction: well-written. No changes are required.

RARP

-What is meant by 2Oberlin in line no 49 of page no 2? Please correct

-Please expand the abbreviation BCR at its first usage in line no 72 on page no 2.

RARN

-Please also write a paragraph on the robotic management of the pediatric renal tumors

(https://onlinelibrary.wiley.com/doi/full/10.1002/pbc.27867)

-In my opinion, another section needs to be added regarding bladder augmentation and appendicovesicostomy. The robotic approach has a major role in bladder augmentation. Please highlight the role of robotic approach in both adults and children.

(https://pubmed.ncbi.nlm.nih.gov/25455178/; https://www.frontiersin.org/articles/10.3389/fped.2019.00001/full; https://link.springer.com/article/10.1007/s11884-016-0370-7)

-In the section "The impalpable factors", please elaborate on ergonomics.  (https://www.liebertpub.com/doi/abs/10.1089/lap.2021.0471)

-Conclusions: well-written. No changes are needed.

 

Response : 

see changes in red in the attached text

Author Response File: Author Response.docx