Single-port robotic surgery in gynecology: first experience in German-speaking countries using the Da Vinci SP system in benign andneoplastic diseases

INTRODUCTION: The Single-Port (SP) surgical system represents a significant advancement in robotic surgery, facilitating procedures through a single incision while overcoming the previously reported limitations of single-site surgery. As the first clinic in the German-speaking countries to use the da Vinci SP system for gynecological surgeries to treat benign and malignant diseases, we aim in this study to report our initial experiences and outcomes. PATIENTS AND METHODS: This retrospective study included 62 patients who underwent gynecological surgeries using the da Vinci SP system. Various procedures were performed, patients diagnosed with both benign and malignant conditions were included in the study. RESULTS: We performed hysterectomy (n = 31); hysterectomy with pectopexy (n = 6); pectopexy alone (n = 7); salpingo-oophorectomy (n = 12); myomectomy (n = 1); and endometriosis surgery (n = 5). The mean operation time was 136.2 ± 70.3 min. The mean docking time was 8.3 ± 2.2 min (range, 3-13). The mean hemoglobin level changed significantly by -0.93 ± 0.61 mmol/L (-1.53 ± 0.98 g/dL) (paired t-test, p < 0.001). No patients required blood transfusion. Notably, no patients developed incisional hernias following the operation. Two patients had minor postoperative complications. The mean hospital stay was 3.6 days ± 1.7 days with operative time as associative factor (+ 0.71 days per operative hour, p = 0.044). CONCLUSION: Our initial experience demonstrates promising results with the use of the da Vinci SP system in gynecology. Single-port robotic surgery seems to be safe and offers several advantages over traditional multi-port systems, with the potential to complement existing platforms. However, it entails a new learning curve for surgeons.