Application of robotic single-site surgery with optional additional port for endometriosis: a single institution’s experience

To evaluate the safety and feasibility of treating stage I–IV endometriosis patients with robotic single-site surgery (RSSS). A retrospective chart review was conducted on 334 patients with endometriosis treated by a single surgeon at a university hospital from January 2015 to November 2019. Surgeries were performed in a single institution between 2015 and 2019. All patients presented with pelvic pain and underwent surgical resection of the lesion. American Society of Reproductive Medicine (ASRM) standards were used to classify endometriosis. The primary goal of this study is to investigate the feasibility and safety of RSSS for surgical resection of stage I–IV endometriosis patients. We will compare patient characteristics and surgical parameters, such as blood loss, operating time, and postoperative complications, across different endometriosis stages to evaluate the effectiveness of this novel technique. RSSS was used for all cases, with no conversions to laparotomy or traditional laparoscopy. One to two additional ports were placed in 41 patients with deeply infiltrating endometriosis (DIE) involving the colorectal and urinary tract and/or extensive pelvic adhesions. Across patient groups, there were no significant differences in age, BMI, fertility history, abdominal surgery history, and hysterectomy ratio (P > 0.05). The median operation time was 140.25 min (range: 85.50–260.00 min, P < 0.05) and median blood loss was 31.25 mL (range: 15–100 mL, P < 0.05). Histopathology supported the diagnosis in 259/334 patients. The undiagnosed patients were associated with lower ASRM scores. For 83.3% of patients (295/334), the length of hospital stay was < 24 h. The postoperative complication rate was 6.0% (20/334), although only two cases were severe. Our results indicate that RSSS is an alternative, safe, and acceptable platform for the surgical treatment of all stages of endometriosis. Similar content being viewed by others

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Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest Dr. Y Huang, Dr. K Duan, Dr. T Koythong, Dr. N Patil, Dr. D Fan, Dr. J Liu, Dr. Z Guan, Dr. X Guan declare that they have no financial disclosures or conflicts of interests. Ethical approval The study protocol was reviewed and approved by the institutional review board at Baylor College of Medicine in 2018 (Reference Number No. H-46727). IRB approval The IRB review board has approved this research at our institution (Ethic Number No. H-46727). Informed consent All 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. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Huang, Y., Duan, K., Koythong, T. et al. Application of robotic single-site surgery with optional additional port for endometriosis: a single institution’s experience. J Robotic Surg 16, 127–135 (2022). https://doi.org/10.1007/s11701-021-01217-4 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11701-021-01217-4