Robotic Single-Site Hysterectomy versus Robot-Assisted Multiport Hysterectomy in Benign Gynecologic Diseases: A Retrospective Comparison of Clinical and Surgical Outcomes

Abstract

Objective: The purpose of this study was to compare clinical and surgical outcomes of robotic single-site hysterectomy (RSSH) and robot-assisted multiport hysterectomy (RH) in benign disease. Methods: We retrospectively reviewed the medical records of 38 women who underwent RSSH (N= 12) or RH (N= 26) for the treatment of benign uterine disease between June 2015 and November 2017. Results: There were no intergroup differences in parity, comorbidities, and number of previous abdominal surgery. Mean age was older (49.5± 5.05 years vs. 44.4± 3.54 years, P= 0.001) and mean body mass index was higher (27.4± 2.47 kg/m 2 vs. 25.3± 3.12 kg/ m 2 , P = 0.045) in RSSH group than RH group. Surgical outcomes, including operative time (165.0 minutes vs. 159.2 minutes, P= 0.727), estimated blood loss (115.8± 33.15 mL vs. 108.1± 56.42 mL, P= 0.662), uterus weight (445.9± 157.21 g vs. 374.5± 197.91 g, P= 0.291), postoperative hospital stay (5.4± 0.51 days vs. 5.8± 1.20 days, P= 0.289), postoperative hemoglobin change in day 1 (1.8 ± 0.89 g/dL vs. 1.4 ± 1.53 g/dL, P = 0.431) and day 3 (2.1 ± 1.32 g/dL vs. 1.7 ± 1.83 g/dL, P = 0.601), and perioperative complications did not significantly differ between two groups. The use of additional analgesics after 6 hours, 24 hours, and 48 hours, and mean NRS score after 6 hours, 24 hours, and 48 hours were not significantly different between two groups. Conclusion: RSSH might be an effective and safe alternative to RH, even if in older and/or obese women with large uteri.

Comparison of Surgical Outcomes between Single-Port Laparoscopic Surgery and Da Vinci Single-Port Robotic Surgery

“…However, in a retrospective study of 104 women conducted by Bogliolo et al, the EBL in the SPRH group was lower than the MPRH group (SPRH, 46 ± 52 mL; MPRH, 150 ± 151 mL, p < 0.001) [ 12 ]. The operation time of the SPRH group in our study was 114 ± 71 min, which was shorter than 165 min and 144 min in the two studies mentioned above [ 2 , 12 ]. In this study, the average uterine weight after the SPRH group was approximately 308.31 g, which was less than the average uterine weight of 445.9 g reported by Park et al [ 2 ] and greater than the average uterine weight of approximately 137.69 g reported by Bogliolo et al [ 12 ].…”

“…The operation time of the SPRH group in our study was 114 ± 71 min, which was shorter than 165 min and 144 min in the two studies mentioned above [ 2 , 12 ]. In this study, the average uterine weight after the SPRH group was approximately 308.31 g, which was less than the average uterine weight of 445.9 g reported by Park et al [ 2 ] and greater than the average uterine weight of approximately 137.69 g reported by Bogliolo et al [ 12 ]. In another study comparing surgical outcomes between SPLH and multi-port laparoscopic hysterectomy (MPLH) groups, the surgical outcomes, such as surgical time, EBL, postoperative Hb change, the size of the uterus, and hospital stay were similar for the SPLH and MPLH groups [ 13 ].…”

“…Two studies have compared the surgical outcomes of SPRH and multi-port robotic hysterectomy (MPRH). There were no statistically significant differences with respect to the characteristics of participants, surgical time, and hospital stay in both the study conducted by Park et al [ 2 ] and the study conducted by Bogliolo et al [ 12 ]. However, in a retrospective study of 104 women conducted by Bogliolo et al, the EBL in the SPRH group was lower than the MPRH group (SPRH, 46 ± 52 mL; MPRH, 150 ± 151 mL, p < 0.001) [ 12 ].…”

“…Minimally invasive surgery (MIS) in gynecology requires only a small incision in the abdomen to insert a laparoscopic camera and various surgical instruments, unlike conventional open surgery with a large incision site. MIS includes laparoscopic, robotic, and natural orifice transluminal surgeries [ 1 , 2 ]. From 2004 to 2007, the number of MIS done in the United States has increased with the trend of increasing interest regarding MIS.…”

“…In many studies comparing the surgical outcomes of SPLS, multi-port laparoscopic surgery (MPLS), SPRS, and multi-port robotic surgery (MPRS), there were no statistical differences in operation time, postoperative hemoglobin (Hb) changes, hospital stay, and additional pain medication [ 2 , 8 , 9 , 10 ]. However, there are few studies that have compared the outcomes of SPLS and SPRS.…”