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

Abstract

Background: The aim of this study is to compare the surgical outcomes of single-port laparoscopic surgery (SPLS) and single-port robotic surgery (SPRS). Methods: We retrospectively analyzed patients who underwent a hysterectomy, ovarian cystectomy, or myomectomy with SPLS or SPRS from January 2020 to July 2022. Statistical analyses were performed using the SPSS chi-square test and student’s t-test. Results: A total of 566 surgeries including single-port laparoscopic hysterectomy (SPLH; n = 148), single-port robotic hysterectomy (SPRH; n = 35), single-port laparoscopic ovarian cystectomy (SPLC; n = 207), single-port robotic ovarian cystectomy (SPRC; n = 108), single-port laparoscopic myomectomy (SPLM; n = 12), and single-port robotic myomectomy (SPRM; n = 56). The SPRH, SPRC, and SPRM groups had a shorter operation time than the SPLS group, although the results were not statistically significant (SPRH vs. SPLH, p = 0.134; SPRC vs. SPLC, p = 0.098; SPRM vs. SPLM, p = 0.202). Incisional hernia occurred as a postoperative complication in two patients only in the SPLH group. Postoperative Hb changes were lower in the SPRC and SPRM groups than in the SPLC and SPLM groups (SPRC vs. SPLC, p = 0.023; SPRM vs. SPLM, p = 0.010). Conclusions: Our study demonstrated that the SPRS had comparable surgical outcomes when compared to the SPLS. Therefore, the SPRS should be considered a feasible and safe option for gynecologic patients.

Effectiveness and safety of SR-ENS-600endoscopic surgical system in benign and malignant gynecological diseases: a prospective, multicenter, clinical trial with 63 cases

“…In the present trial, the demographic information of patients was similar to that of the other two studies using the da Vinci SP [ 4 , 5 ], except that the BMI of patients who received hysterectomy in our study was lower than that of Kim’s study (23.24 ± 2.50 vs. 24.40 ± 3.74, p = 0.010) [ 4 ].…”

“…This also led to a longer mean operating time in all surgeries compared with that in Shin’s study (156.87 ± 75.34 vs. 126.3 ± 61.6 min, p = 0.002) [ 5 ]. After cystectomy/adnexectomy, hemoglobin was reduced more than that reported by Kim [ 4 ]. Almost all surgeons who started with cystectomy/adnexectomy for practice might account for this result, and we noticed that as the trial went on, there was less bleeding with cystectomy/adnexectomy.…”

“…In regard to perioperative parameters, the operating time showed no difference for cystectomy/adnexectomy and myomectomy but was longer for hysterectomy in our study (167.66 ± 79.65 vs. 114.71 ± 44.20 min, p < 0.001) [ 4 ]. The possible reason for this was because one center included patients with multiple-myoma, especially one nullipara patient with both adenomyosis and myoma whose uterus was irregularly enlarged, parametrium was severely shortened and lacked mobility, with severe uterosacral ligament adhesion.…”

“…Nine (14.3%) patients received cystectomy/adnexectomy, 10 (15.9%) underwent myomectomy, 35 (55.6%) received hysterectomy, and 9 (14.3%) patients underwent staging surgery for endometrial carcinoma. Other demographic information of the patients compared with the literature [ 4 , 5 ] is shown in Table 3 and Fig. 3 .…”

“…Perioperative indicators of the patients compared to the literature [ 4 , 5 ] are shown in Table 4 and Fig. 4 .…”