ENHANCED RECOVERY PATHWAYS AFTER ROBOT-ASSISTED UROLOGICAL SURGERY

Robot-assisted urological surgery has reduced surgical trauma, but the quality of postoperative recovery still depends on coordinated perioperative care. Enhanced recovery pathways combine patient preparation, standardized anesthesia, fluid stewardship, opioid-sparing analgesia, early nutrition, mobilization, and explicit discharge criteria. This review critically synthesizes evidence published from 2020 to 2025 on enhanced recovery after robot-assisted radical prostatectomy, radical cystectomy, partial nephrectomy, and related renal surgery. A structured narrative approach was used, prioritizing comparative studies, randomized trials, prospective cohorts, systematic reviews, and contemporary implementation studies with verifiable digital object identifiers. Across procedures, the most consistent benefits are earlier mobilization, faster gastrointestinal recovery, shorter hospitalization, reduced unnecessary tubes and intravenous therapy, and greater feasibility of same-day or early discharge without a clear increase in major complications or readmissions in appropriately selected patients. Benefits are most pronounced when baseline care is heterogeneous or recovery is intrinsically complex, as after radical cystectomy. In mature prostatectomy programs, enhanced pathways increasingly function as reliability systems rather than dramatic length-of-stay interventions, and recent randomized evidence suggests diminishing incremental gains when standard care is already optimized. For renal surgery, evidence is promising but less extensive.