Early experience with robot-assisted radical prostatectomy using the Toumai system: outcomes from the first African series of 134 patients.

Robot-assisted radical prostatectomy (RARP) is widely used for localized prostate cancer, offering enhanced precision and potential preservation of urinary and sexual function. Data on new robotic platforms in Africa are limited. Evaluate the safety, feasibility, and early perioperative, oncological, and functional outcomes of robot-assisted radical prostatectomy performed using the Toumai robotic system and determine whether these outcomes are consistent with those reported for established robotic platforms. We retrospectively analyzed 134 patients who underwent RARP with the Toumai system between May 2024 and November 2025. Preoperative data, perioperative parameters, pathological findings, functional outcomes, and postoperative PSA were collected. Urinary continence and erectile function were assessed at 1, 3, 6, 9, and 12 months postoperatively. The mean age was 67.3 years and mean preoperative PSA was 13.47 ng/mL. Most patients were intermediate risk (52.2%). Mean operative time was 262.8 min, with low blood loss (65.9 mL) and one conversion to open surgery (0.75%). Mean hospital stay was 1.4 days. Postoperative complications were rare (14.9% Clavien-Dindo I-II, 1.5% major), with no mortality. Positive surgical margins occurred in 11.1%, and lymph node involvement in 8%. After a median follow-up of 6 months (IQR: 3-18 months), 19.5% of patients showed biochemical recurrence. Urinary continence improved progressively from 30.6% at 1 month to 60.9% at 9 months and 88.2% at 12 months. Spontaneous erectile function increased from 17.6% at 3 months to 41.2% at 12 months. RARP with the Toumai system is safe and feasible in an African setting, showing acceptable early oncological outcomes with short follow-upand progressive functional recovery. Early biochemical control and continence rates are encouraging, while erectile function recovery remains gradual, highlighting the impact of surgical experience and the need for structured rehabilitation and long-term follow-up.