Procedure-specific impact of body mass index on robot-derived intraoperative telemetry—evidence from 100 consecutive robot-assisted urologic procedures: A retrospective single-surgeon cohort study

Introduction Robotic platforms automatically record intraoperative telemetry, but body mass index (BMI) effects on these micro-metrics are unclear.Aim To evaluate BMI-telemetry associations overall and by procedure, focusing on robotassisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN). Materials and methodsRetrospective consecutive single-surgeon cohort of 100 robotassisted urologic procedures performed between 02 Apr 2024 and 22 Dec 2025.BMI was calculated from routine height and weight as weight (kg) / height² (m²).Primary outcome was console time; secondary outcomes were instrument active time and camera-installation rate.Associations were assessed using Spearman correlation and prespecified procedure-stratified models (log-linear regression for time outcomes; negative binomial regression with log(console time) offset for rate outcomes). ResultsThe cohort included RARP (n = 43), RAPN (n = 36), and other procedures (n = 21); BMI and console time were available for 97 cases.BMI correlated with console time overall (r = 0.272; P = 0.007) and in RARP (r = 0.487; P = 0.001; n = 40), but not in RAPN (r = 0.090; P = 0.603; n = 36).In adjusted RARP models (age and extended pelvic lymph node dissection), each +5 kg/m² BMI was associated with +16.8% longer console time (95% CI, 4.0-31.2;P = 0.009), +17.7% longer instrument active time (95% CI, 4.0-33.2;P = 0.010), and a higher camera-installation rate (IRR 1.36 per +5 kg/m²; 95% CI, 1.07-1.72;P = 0.012).Quantile regression suggested a larger effect in prolonged RARP cases (75th percentile: +45 min per +5 kg/m²; P = 0.0002). ConclusionsHigher BMI was associated with longer surgeon-controlled times and increased camera-management burden in RARP but not in RAPN.Telemetry may support BMI-adapted scheduling and workflow optimization.