Robotic Single-Port Hysterectomy Versus Robotic Multi-Site Hysterectomy in Benign Gynecologic Diseases: A Retrospective Comparison

Abstract

<h3>Study Objective</h3> The aim of this study is to compare clinical and surgical outcomes of robotic single-port hysterectomy (RSPH) using the da Vinci SP® surgical system and robotic multi-site hysterectomy (RMSH) using the da Vinci Xi® surgical system in benign disease. <h3>Design</h3> Multicenter retrospective case-controlled study. <h3>Setting</h3> A university tertiary care hospital. (Ewha Womans University, Seoul Hospital and MokDong Hospital, Seoul, Republic of Korea) <h3>Patients or Participants</h3> It is enrolled robotic single-port hysterectomy cases (RSPH, n=67) and robotic multi-site hysterectomy cases (RMSH, n=67) from Nov. 2018 to Jun 2020.Nov. 2015 in benign gynecologic diseases. <h3>Interventions</h3> All patients underwent RSPH or RMSH. Basic information such as age, BMI, previous surgery history, delivery history and postoperative results such as intraoperative blood loss and postoperative complications were collected and compared. <h3>Measurements and Main Results</h3> There were no statistical differences of clinical characteristics such as age, BMI and parity. The weight of specimen was higher in RMSH group than that in RSPH group (302.64±190.56 vs 369.24±181.70, p-value 0.04). The estimated blood loss (EBL) and the change in hemoglobin after surgery in RSPH group were less than those in RMSH group (97.39±113.79ml vs 224.93±152.29ml, p-value <0.01, 1.51±1.08 vs 2.54±1.08, p- value <0.01). Even when the weight difference between the two groups was corrected and analyzed, the EBL was significantly less in RSPH group (p-value <0.01). There was no significant difference between the two groups of total operative time, hospital stays and postoperative complications between the two groups. <h3>Conclusion</h3> In this study, robotic single-port hysterectomy using da Vinci SP® surgical system is reliable procedures as like robotic multi-site hysterectomy except huge cases. Rather than, surgeons can reduce perioperative bleeding during RSPH by performing the sophisticated surgery. However further studies are required to clarify the feasibility and safety of the new robotic surgical system.