The feasibility and short-term safety of single-site hysterectomy: a retrospective cohort study of a novel robotic platform.

BACKGROUND

Robotic-assisted laparoscopic single-site hysterectomy is popular among patients and surgeons due to good cosmetic outcomes and fast recovery. However, questions remain such as loss of triangulation and instrument collision. Our aim is to test the feasibility and safety of a purpose-designed single-site robotic surgical platform mainly in hysterectomies.

METHODS

We retrospectively collected patients who had undergone hysterectomy by SHURUI (SR-ENS-600) robotic surgical system in the First Affiliated Hospital of Xi'an Jiaotong University. Initial cases as control were also collected including da Vinci single-site (IS4000) and multi-port (IS3000 and IS4000) hysterectomies performed by the same surgical team. The main outcome was surgical feasibility rate (valid surgeries/total cases × 100%). Short-term post-operative outcomes and complications were recorded and compared between three groups.

RESULTS

From Dec, 2nd, 2023 to Mar, 1st, 2024, 19 cases of hysterectomies were enrolled, including 6 myomas, 2 adenomyosis, 9 cervical high-grade squamous intraepithelial lesion/stage Ia1 cancers, and 2 stage Ia endometrial cancers. Seventeen cases of da Vinci single-site surgeries and 20 cases of multi-ports surgeries were also included for comparation. Intra-operative bleeding volume was significantly lower in SHURUI group compared with da Vinci single-site and multi-ports groups (40.5 mL vs 47.4 mL vs 58.5 mL, P = 0.046 and 0.028). Post-operative time to flatus was also shorter in SHURUI group compared with da Vinci single-site and multi-port surgeries (22.9 h vs. 33.5 h vs. 28.6 h, P = 0.054 and 0.001). Follow-up for SHURUI group lasted for 3 months with no complications.

CONCLUSIONS

SHURUI robotic surgery was feasible and safe in hysterectomies. It also had comparable outcomes with da Vinci robotic platform and approaches.