What is the role of robotic surgery in ovarian cystectomy with fertility preservation?

Ju Hye Lee, So Yun Park, Kyungah Jeong, Ha Yeoung Yun, Hye Won Chung
Journal of robotic surgery · 2023 · vol. 17(6) , pp. 2743–2747 · doi:10.1007/s11701-023-01704-w · PMID:37690086 · PMC10678793 · W4386583818
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study compared robotic single-site (RSS) and single-port laparoscopic (SPL) ovarian cystectomy, finding that RSS surgery resulted in a significantly lower decrease in post-operative AMH.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective chart review compared robotic single-site (RSS) ovarian cystectomy versus single-port laparoscopic (SPL) cystectomy in 156 reproductive-aged patients, assessing fertility preservation using pre- and postoperative anti-Müllerian hormone (AMH) changes and relating AMH reduction to cyst features and surgical factors. Across groups, average age, cyst diameter, number of locules, and mean operative time (including robotic docking time) were similar, and there were no significant differences in pre- versus post-operative AMH levels overall. However, the percentage decrease in post-operative AMH was significantly lower with RSS than with SPL (24.2% vs 34.9%), while AMH declined more in patients with endometriosis, bilateral disease, and pelvic adhesions; longer operation time, larger cysts, and multilocular cysts correlated with greater AMH reduction. The study’s main limitation is its retrospective design and non-random allocation, with more complex cases in the RSS group. This paper is centrally about endometriosis-related fertility preservation because it specifically analyzes AMH changes after ovarian cystectomy and reports that AMH decreases more in patients with endometriosis, directly informing endometriosis research on ovarian reserve after surgical treatment.

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Abstract

To investigate the role of robotic single-site (RSS) ovarian cystectomy in fertility preservation, which was compared with single-port laparoscopic (SPL) surgery based on AMH changes. We retrospectively analyzed medical records of total 156 patients who underwent SPL (n = 72) or RSS (n = 84) surgery with the da Vinci® Si or Xi system. The pre/post-operative AMH levels and total diameter of ovarian cysts were measured. In addition to the surgical method, AMH changes were compared according to the laterality, multiplicity, and pathology of ovarian cysts. A comparison of the characteristics of the SPL group and RSS group, revealed that there were no significant differences in the average age, the diameter of the ovarian cyst, and the number of locule. There were also no statistical differences between the pre-operative and post-operative AMH levels and the average surgical time including the docking time in robotic surgery. A comparison based on the surgical methods, revealed that the decrease in post-operative AMH was lower in the RSS group (24.2 ± 35.9%) than in the SPL group (34.9 ± 29.1%) significantly (p = 0.044). In patients with endometriosis, the decrease in AMH was greater, than that in patients without endometriosis. A longer operation time, larger ovarian cysts and multi-locular cysts were associated with lower AMH level in both the SPL and RSS groups (Pearson correlation coefficient: - 0.320, p = 0.0001, - 0.218, p = 0.007, - 0.236, p = 0.003, respectively). RSS ovarian cystectomy could be a promising new therapeutic option for fertility preservation in complex cases to avoid an additional side port.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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References (19)

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