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Robotic surgery is used for the surgical removal of female pelvic malignancies and encompasses procedures as radical cystectomy and radical hysterectomy. The aim of this paper is to provide an update of level 1 literature evidence about the outcomes of robotic surgery compared to other surgical approaches for the treatment of bladder, endometrial and cervical cancer. A non-systematic search of the PubMed and Scopus databases was conducted to identify peer-reviewed randomized controlled trials (RCTs) comparing surgical approaches for radical cystectomy and hysterectomy. To the purpose of capturing the lastest updates, 2020-2022 literature was reviewed. In the field of radical cystectomy, two RCTs supported the implementation of robotics as a more beneficial approach than open surgery -in terms of faster recovery, less thromboembolic events, less infectious events. In gynecology, despite robotics is accepted for the treatment of early endometrial tumors, the role of minimally invasive surgery (MIS) for the treatment of cervical cancer is still debated, with two recent systematic reviews and meta-analyses reporting conflicting results. Two-decades after the introduction of robotic surgery, there is still a number of current studies evaluating its role for the treatment of urological pelvic malignancies, especially for bladder cancer. The role of robotic surgery alone for the treatment of gynecological malignancies has been scarcely addressed with robotics being mostly evaluated as a part of MIS; updates about MIS for the treatment of cervical cancer continue to be ongoing.

Background: Since the Da Vinci system was introduced in the gynaecological profession, for benign and most malignant procedures, it appeared that using 5 incisions for trocar insertion could jeopardize the system's mini-invasiveness. To protect this important characteristic, robotic laparoendoscopic single-site surgery was developed and authorized for gynaecological use in 2013. Using a single small incision for the entire treatment appears to be a promising attempt to improve cosmetic results while lowering wound infections, postoperative pain, and recovery time. After nearly ten years of use, several limitations of this technique became apparent, such as a limited set of non-articulating instruments and electrical possibilities compared to multiport surgery, smoke evacuation and visual impairment. By examining the most relevant research, the goal of this review was to emphasize the indications, risks, and benefits of R-LESS in gynaecological surgery. Methods: A scoping review was conducted on Pubmed, Scopus, Web of Science, and Embase. Publications in English or Italian in the previous 10 years on the use of single-site robotic surgery in gynaecology for benign disorders were included. Results: This review includes 37 of the 297 papers that were retrieved. Myomectomy, hysterectomy, pelvic floor surgery, and endometriosis were the most common indications for single-site surgery. Several studies have reported R-LESS usage in cancer patients. According to the data analysis, the R-LESS approach is comparable to robotic multi-port surgery as regards feasibility and safety, with faster operative and postoperative durations, reduced pain, and a superior cosmetic outcome. Conclusions: The single-port robotic technique is gaining popularity. Our findings provide preliminary evidence of the global experience of surgical teams. Standardizing operative durations and conducting comparative research on the R-LESS learning curve represent one of the most significant future difficulties, as do surgical outcomes, costs, and patient satisfaction in the long run.

Objectives:The aim of this study was to compare robotic-assisted surgery (RS) and vaginal surgery (VS) for pelvic organ prolapse (POP) through an updated review. Mechanism: We performed a comprehensive review from March 1, 2022 up to April 1, 2022. All comparative studies that compared RS and VS for the management of POP were included. Findings in Brief: A total of 10 non-randomized studies including 1424 participants were included in the review. The results revealed that robotic surgery (RS) was associated with longer operative time, less estimated blood loss, and fewer postoperative complications. There were no differences between the length of hospital stays, intraoperative complications and effectiveness between the two groups. Conclusions: RS and VS have comparable efficacy, although RS was associated with less blood loss and postoperative complications. The choice of surgical procedure depends on the surgeon's discretion and the patient's preference.

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