Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

Riemma, Gaetano; Pasanisi, Francesca; Reino, Antonella; Solazzo, Maria Cristina; Ronsini, Carlo

doi:10.3390/medicina59020411

Cited by 3 publications

(4 citation statements)

References 35 publications

(48 reference statements)

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“…In a 2023 systematic review of 219 articles on single‐port robot‐assisted hysterectomy in patients with benign gynecological disease conducted by Riemma et al, 4 only 8 studies satisfied the criteria, and 212 patients were included. For hysterectomy, single‐port robot‐assisted surgery can be performed safely.…”

Section: Discussionmentioning

confidence: 99%

Initial experience and surgical outcomes of robotic‐assisted total hysterectomy using the da Vinci SP surgical system

Miyamura,

Takada,

Ohwaki

et al. 2024

Asian J Endoscop Surgery

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IntroductionThe da Vinci SP surgical system is a surgical platform capable of implementing robotic‐assisted surgery through a single port and was first introduced in Japan at our hospital. In this paper, we describe our experience of the initial introduction of the da Vinci SP surgical system and its surgical outcomes. This is the first report on the surgical outcomes of using da Vinci SP, and its comparison with the conventional system in Japan.MethodsAfter developing an application for a highly difficult new medical technology in‐house, we compared the surgical outcomes (median values) of 15 patients who had undergone total hysterectomy at our hospital using the da Vinci SP (1‐port) system (SP group) for uterine myoma after March 2023 and of 154 patients who underwent total hysterectomy using the conventional da Vinci Xi (four ports) system (Xi group) for uteri weighing <500 g.ResultsThe results of the comparison of the characteristics between 15 patients in the SP group and 154 patients in the Xi group were as follows: uterus weight (g): 230 (90–500) versus 222 (55–496) (p = .35); surgical time (minutes): 199 (171–251) versus 198 (88–387) (p = .63); intraoperative blood loss (mL): 13 (5–82) versus 20 (2–384) (p = .17); and rate of surgical complication (%): 0.0 versus 1.3 (p = .66). The data indicated a comparable weight of the resected uterus, surgical time, intraoperative blood loss, and rate of surgical complications between the two groups.ConclusionRobotic‐assisted total hysterectomy using the da Vinci SP surgical system allowed clinicians to safely perform surgeries according to the conventional systems.

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Section: Discussionmentioning

confidence: 99%

Initial experience and surgical outcomes of robotic‐assisted total hysterectomy using the da Vinci SP surgical system

Miyamura,

Takada,

Ohwaki

et al. 2024

Asian J Endoscop Surgery

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“…The recognition of key microbiota would pave the way for new diagnostic and therapeutic strategies, including both prebiotics and probiotics, that can be implemented before considering surgical approaches. That would be crucial in helping patients avoid hysterectomy; fertility-sparing techniques can also be considered [ 90 , 91 , 92 ]. Lastly, more knowledge regarding miRNAs may help clinicians better understand the natural evolution of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, more knowledge regarding miRNAs may help clinicians better understand the natural evolution of this disease. The risk of EC spreading via lymphatic, hematologic, or contiguous routes may influence treatment options in terms of molecular profile, adjuvant therapy, and personalizing surgery with procedures such as lymphadenectomy, omentectomy, or adnexectomy [ 81 , 92 , 93 , 94 , 95 , 96 ]. Moreover, we call attention to other novel molecular signatures, such as circular RNAs and proteins, that are different among EC patients and healthy control subjects [ 97 , 98 ].…”

Section: Discussionmentioning

confidence: 99%

MicroRNA Expression in Endometrial Cancer: Current Knowledge and Therapeutic Implications

Iavarone,

Molitierno,

Fumiento

et al. 2024

Medicina

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Background and Objectives: An extracellular vesicle is part of a class of submicron particles derived from cells, mediating cellular crosstalk through microRNA (miRNA). MiRNA is a group of RNA molecules, each of which consists of 15–22 nucleotides and post-transcriptionally modulates gene expression. The complementary mRNAs—onto which the miRNAs hybridize—are involved in processes such as implantation, tumor suppression, proliferation, angiogenesis, and metastasis that define the entire tumor microenvironment. The endometrial biopsy is a standard technique used to recognize cellular atypia, but other non-invasive markers may reduce patient discomfort during the use of invasive methods. The present study aims to examine the distribution and the regulation of the differentially expressed miRNAs (DEMs) and EV-derived substances in women with endometrial cancer. Materials and Methods: We systematically searched the PubMed, EMBASE, Scopus, Cochrane Library, and ScienceDirect databases in April 2023, adopted the string “Endometrial Neoplasms AND Exosomes”, and followed the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We selected all the studies that included patients with endometrial cancer and that described the regulation of miRNA molecules in that context. The differences in molecule expression between patients and controls were evaluated as significant when the proteins had a fold change of ±1.5. Results: Seventeen records fulfilled the inclusion criteria: a total of 371 patients and 273 controls were analyzed. The upregulated molecules that had the widest delta between endometrial cancer patients and controls—relative expression ≥ 1 > 3 log2(ratio)—were miR-20b-5p, miR-204-5p, miR-15a-5p, and miR-320a. In particular, miR-20b-5p and miR-204-5p were extracted from both serum and endometrial specimens, whereas miR-15a-5p was only isolated from plasma, and miR-320a was only extracted from the endometrial specimens. In parallel, the most downregulated miRNA in the endometrial cancer patients compared to the healthy subjects was miR-320a, which was found in the endometrial specimens. Conclusions: Although their epigenetic regulation remains unknown, these upregulated molecules derived from EVs are feasible markers for the early detection of endometrial cancer. The modulation of these miRNA molecules should be assessed during different treatments or if recurrence develops in response to a targeted treatment modality.

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“…The advantages of laparoscopy for urogynecologic surgery have been demonstrated by various studies ( 13 ), including a randomized study by Carey et al ( 14 ). These advantages include the ability to visualize and dissect all anatomic structures, minimizing blood loss and the risks of complications, primarily associated with blind procedures ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Multicentric data analysis of the learning curve for laparoscopic Shull's repair of pelvic floor defects

Cianci,

Ronsini,

Riemma

et al. 2024

Front. Surg.

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IntroductionPelvic organs prolapse remains a significant health concern affecting millions of women worldwide. The use of native tissues to suspend the apex has acquired relevance in urogynecologic surgery. One of the most commonly used procedures performed without mesh is the technique described by Shull, consisting of suturing the vaginal apex to the uterosacral ligaments. The objective of the study is to evaluate the learning curve of laparoscopic Shull's repair for the correction of pelvic floor defects, including the surgery time and surgical outcomes.Materials and methodsThis is a retrospective study conducted at the Policlinico G. Martino, University of Messina, Messina, Italy, and Policlinico Vanvitelli, Vanvitelli University, Naples, Italy. All patients affected by grade I-IV POP, consisting of apical prolapse with or without cystocele, and who underwent laparoscopic Shull's technique for prolapse correction were enrolled. The endpoints to estimate the learning curve for the procedure were the percentage of laparoscopic procedures completed, operative time, and the early complication rate.ResultsA total of 31 laparoscopic Shull repairs were collected for the study. To evaluate the learning curve of the technique, we divided the 31 cases into three different groups: Procedures 0–10; 11–20; 21–31. The parameter for evaluating technique learning was the operative time. Group 21–31 demonstrated an operative time of 97 min (SD 20), compared with 121 min (SD 23) in group 0–10 and 120 min (SD 13) in group 11–20. A comparison of these means through ANOVA showed a p-value of 0.01 for the entire system, and 0.95 for the comparison between 0 and 10 and 11–20, 0.04 for 0–10 vs. 21–31, and 0.02 between 11 and 20 and 21–31.ConclusionsThe rate of surgical improvement in terms of time became effective after an average of 20 procedures. However, the improvement seems to be effective case by case for surgeons skilled in basic endoscopy.

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Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

Cited by 3 publications

References 35 publications

Initial experience and surgical outcomes of robotic‐assisted total hysterectomy using the da Vinci SP surgical system

Initial experience and surgical outcomes of robotic‐assisted total hysterectomy using the da Vinci SP surgical system

MicroRNA Expression in Endometrial Cancer: Current Knowledge and Therapeutic Implications

Multicentric data analysis of the learning curve for laparoscopic Shull's repair of pelvic floor defects

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