{"paper_id":"fc940013-3d45-4a56-b748-92b0ce328c7c","body_text":"Abstract\nThis study evaluated the feasibility and safety of 3-port robotically assisted laparoscopic hysterectomy (RALH), using a consecutive series of women who underwent 3-port RALH in a university hospital. From November 2010 until June 2013 we operated on 53 women, whose mean age was 48.4 ± 7.7 years (range 35–68 years), and mean body mass index was 27.1 ± 5.1 kg/m2 (range 19.5–42.9 kg/m2). The indications for hysterectomy were myoma in 31 (58.5 %), adenomyosis in 10 (18.9 %), cervical dysplasia in 4 (7.5 %), neoplasia in 4 (7.5 %), and recurrent polyps or postmenopausal bleeding in the remaining 4 women (7.5 %). We performed total RALH in 50 cases (94.3 %) and subtotal in the others. The median duration of total intervention was 169 min (interquartile range 147.5–206.5 min). The mean weight of the uterus was 209.8 ± 166.6 g (range 36–790 g) and mean estimated blood loss was 72.3 ± 75.9 ml (range 0–300 ml). There were no perioperative complications, in particular no blood transfusions nor conversions to laparotomy. The median hospital stay was 4 days (interquartile range 3–4 days). One patient was reoperated 1 month later for vaginal vault hematoma and another was readmitted 3 weeks post-operatively due to vaginal vault dehiscence after premature intercourse, but did not require reoperation. Three-port RALH is feasible and safe for simple hysterectomy. We believe this experience using minimum ports to be useful to prepare for robotically assisted single-port hysterectomy.\nSimilar content being viewed by others\nReferences\nJacoby VL, Autry A, Jacobson G, Domush R, Nakagawa S, Jacoby A (2009) Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol 114:1041–1048\nReich H, DeCaprio J, McGlynn F (1989) Laparoscopic hysterectomy. Gynecol Surg 5:213–216\nWright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, Neugut AI, Herzog TJ, Hershman DL (2013) Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease. JAMA 309:689–698\nPayne TN, Dauterive FR (2008) A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol 15:286–291\nSarlos D, Kots L, Stevanovic N, Schaer G (2010) Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control study. Eur J Obstet Gynecol Reprod Biol 150:92–96\nPasic RP, Rizzo JA, Fang H, Ross S, Moore M, Gunnarsson C (2010) Comparing robot-assisted with conventional laparoscopic hysterectomy: impact on cost and clinical outcomes. J Minim Invasive Gynecol 17:730–738\nParaiso MF, Ridgeway B, Park AJ, Jelovsek JE, Barber MD, Falcone T, Einarsson JI (2013) A randomized trial comparing conventional and robotically assisted total laparoscopic hysterectomy. Am J Obstet Gynecol 208(368):e1–e7\nBetcher RE, Chaney JP, Lacy PR, Otey SK, Wood DJ (2014) Analysis of postoperative pain in robotic versus traditional laparoscopic hysterectomy. J Robotic Surg 8:35–41. doi:10.1007/s11701-013-0418-z\nPelosi MA, Pelosi MA 3rd (1991) Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med 88:721–726\nChittawar PB, Magon N, Bhandari S (2013) Laparoendoscopic single-site surgery in gynecology: LESS is actually how much less? J Midlife Health 4:46–51\nFader AN, Cohen S, Escobar PF, Gunderson C (2010) Laparoendoscopic single-site surgery in gynecology. Curr Opin Obstet Gynecol 22:331–338\nUppal S, Frumovitz M, Escobar P, Ramirez PT (2011) Laparoendoscopic single-site surgery in gynecology: review of literature and available technology. J Minim Invasive Gynecol 18:12–23\nSpuhler SC, Sauthier PG, Chardonnens EG, De Grandi P (1994) A new vaginal extractor for laparoscopic surgery. J Am Assoc Gynecol Laparosc 1:401–404\nReynolds RK, Advincula AP (2006) Robot-assisted laparoscopic hysterectomy: technique and initial experience. Am J Surg 191:555–560\nKho RM, Hilger WS, Hentz JG, Magtibay PM, Magrina JF (2007) Robotic hysterectomy: technique and initial outcomes. Am J Obstet Gynecol 197(113):e1–e4\nBoggess JF, Gehrig PA, Cantrell L, Shafer A, Mendivil A, Rossi E, Hanna R (2009) Perioperative outcomes of robotically assisted hysterectomy for benign cases with complex pathology. Obstet Gynecol 114:585–593\nSarlos D, Kots L, Stevanovic N, von Felten S, Schar G (2012) Robotic compared with conventional laparoscopic hysterectomy: a randomized controlled trial. Obstet Gynecol 120:604–611\nHur HC, Guido RS, Mansuria SM, Hacker MR, Sanfilippo JS, Lee TT (2007) Incidence and patient characteristics of vaginal cuff dehiscence after different modes of hysterectomies. J Minim Invasive Gynecol 14:311–317\nRamirez PT, Klemer DP (2002) Vaginal evisceration after hysterectomy: a literature review. Obstet Gynecol Surv 57:462–467\nHur HC, Donnellan N, Mansuria S, Barber RE, Guido R, Lee T (2011) Vaginal cuff dehiscence after different modes of hysterectomy. Obstet Gynecol 118:794–801\nKho RM, Akl MN, Cornella JL, Magtibay PM, Wechter ME, Magrina JF (2009) Incidence and characteristics of patients with vaginal cuff dehiscence after robotic procedures. Obstet Gynecol 114:231–235\nSarlos D, Kots LA (2011) Robotic versus laparoscopic hysterectomy: a review of recent comparative studies. Curr Opin Obstet Gynecol 23:283–288\nPoon CM, Chan KW, Lee DW, Chan KC, Ko CW, Cheung HY, Lee KW (2003) Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 17:1624–1627\nConflict of interest\nPatrick Dällenbach and Patrick Petignat declare that they have no conflict of interest.\nEthical standard\nAll procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nDällenbach, P., Petignat, P. Perioperative outcomes of three-port robotically assisted hysterectomy: a continuous series of 53 cases. J Robotic Surg 8, 221–226 (2014). https://doi.org/10.1007/s11701-014-0454-3\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s11701-014-0454-3","source_license":"CC0","license_restricted":false}