8683 Robotic Single-Site Versus Laparoscopic Single-Site Hysterectomy in Benign Gynecologic Disease: A Single Surgeon's Experience

Abstract

<h3>Study Objective</h3> The purpose of this study is to evaluate the feasibility and safety of robotic single-site hysterectomy (RSSH), and to compare postoperative outcomes between RSSH and laparoscopic single-site hysterectomy (LSSH) for benign gynecological disease. <h3>Design</h3> A retrospective study was conducted of all cases of RSSH and LSSH performed from January 2018 to February 2021. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> Among 170 consecutive patients who had undergone total hysterectomy for benign gynecologic disease, surgical outcomes were compared between the RSSH group (n=92) and the LSSH group (n=78). <h3>Interventions</h3> RSSH was performed using the da Vinci Xi robotic system with Lab single®, and LSSH using a handmade globe port at the umbilicus. And all operations were performed by a single gynecologic oncologic surgeon. <h3>Measurements and Main Results</h3> All operations were completed with no additional port insertion or conversion to laparotomy. There were no significant differences in the characteristics of the patients between the 2 study groups. The uterus weight was 389 ± 190 in the RSSH group and 390 ± 225 in the LSSH group. Mean operation time was higher in the RSSH group than the LSSH group (85.3 ± 26.5 vs 73.6 ± 26.5 min, <i>p <</i> 0.0001). However, the postoperative pain score was lower in the RSSH group. The mean NRS score after 2 hours, 4 hours, 8 hours, and 12 hours was significantly lower than the LSSH group (<i>p <</i> 0.0001). Operative Mean hemoglobin drop (1.4 ± 0.9 vs 1.3 ± 1.0 g/dl, p = 0.122) and Mean postoperative day (3.1 ± 0.6 vs 3.1 ± 0.5 days, p = 0.943) did not significantly differ between two groups. <h3>Conclusion</h3> The RSSH using the da Vinci Xi system is feasible and safe in appropriately select patients with benign gynecologic disease. Additionally, prospective randomized clinical trials will be able to evaluate the potential benefits of Robotic single-site surgery.