Comparison of Surgical Outcomes Between Single-Port Assess Laparoscopic and Single-Site Robotic Surgery in Benign Gynecologic Diseases: A Single-Center Cohort Study

Background: /Objectives: To compare the outcomes of single-port assessment laparoscopic surgery (SPALS) and single-site robotic surgery (SSRS) for benign gynecological diseases. Methods: The clinical data of 367 patients who underwent gynecologic surgery at Sejong Chungnam National University Hospital from October 2020 to December 2023 were analyzed retrospectively. Of these 367 patients, 197 received SPALS while 170 underwent SSRS. The SPALS group comprise 87 hysterectomies, 107 adnexal surgeries (44 cystectomies, 63 adnexectomies) and 1 myomectomy. The SSRS group includes 68 myomectomies, 61 adnexal surgeries (52 cystectomies, 9 adnexectomies), 35 hysterectomies, and 4 sacrocolpopexies. Results: The results showed that both surgical techniques were successful, and no patients underwent open surgery. There were no significant differences in the baseline characteristics between the two groups. Compared with the SPALS group, the SSRS group had younger age (39.8±9.5 vs 44.5±12.3 years, p = 0.001). Severe intra-abdominal adhesions were more frequently observed in the SSRS group (p = 0.004). Operation time (118.1±65.9 vs 57.1±27.3 min, p = 0.001) and gas passing time (39.4±15.37 vs 30.4±13.5 hours, p = 0.001) were found to be longer, along with more hospital days (4.26±1.02 vs 4.02±0.8 days, p = 0.012), in SSRS group. However, there were no significant differences between the two groups in terms of intraoperative blood loss, intraoperative complications, or readmission rates. Conclusions: SSRS offers a feasible and promising approach for treating gynecological benign diseases. Younger and lower parity patients tend to have SSRS, compare to SPALS, and SSRS was mainly used for myomectomy and complex adnexal surgery. However, operation time and gas passing time were found to be longer in SSRS group.