The feasibility and short-term safety of single-site hysterectomy: a retrospective cohort study of a novel robotic platform

Background Robotic-assisted laparoscopic single-site hysterectomy is popular among patients and surgeons due to good cosmetic outcomes and fast recovery. However, questions remain such as loss of triangulation and instrument collision. Our aim is to test the feasibility and safety of a purpose-designed single-site robotic surgical platform mainly in hysterectomies.

We retrospectively collected patients who had undergone hysterectomy by SHURUI (SR-ENS-600) robotic surgical system in the First Affiliated Hospital of Xi’an Jiaotong University. Initial cases as control were also collected including da Vinci single-site (IS4000) and multi-port (IS3000 and IS4000) hysterectomies performed by the same surgical team. The main outcome was surgical feasibility rate (valid surgeries/total cases × 100%). Short-term post-operative outcomes and complications were recorded and compared between three groups.

From Dec, 2nd, 2023 to Mar, 1st, 2024, 19 cases of hysterectomies were enrolled, including 6 myomas, 2 adenomyosis, 9 cervical high-grade squamous intraepithelial lesion/stage Ia1 cancers, and 2 stage Ia endometrial cancers. Seventeen cases of da Vinci single-site surgeries and 20 cases of multi-ports surgeries were also included for comparation. Intra-operative bleeding volume was significantly lower in SHURUI group compared with da Vinci single-site and multi-ports groups (40.5 mL vs 47.4 mL vs 58.5 mL, P = 0.046 and 0.028). Post-operative time to flatus was also shorter in SHURUI group compared with da Vinci single-site and multi-port surgeries (22.9 h vs. 33.5 h vs. 28.6 h, P = 0.054 and 0.001). Follow-up for SHURUI group lasted for 3 months with no complications.

SHURUI robotic surgery was feasible and safe in hysterectomies. It also had comparable outcomes with da Vinci robotic platform and approaches. Graphical abstract Similar content being viewed by others Data availability The data that support the findings of this study are available from the corresponding author, Q.L., upon reasonable request.

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We thank the selfless participations of the nurses and assistants from the operation team. We also thank the patients for their kind devotion. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author information Authors and Affiliations Contributions Conceptualization: QL; data curation: LZ and RC; formal analysis: LZ and RC; methodology: QL and YL; project administration: YX; Resources: QL and ZP; Writing—original draft: LZ and ZP; Writing—review & editing: YX and QL. All authors have read and agreed to the published version of the manuscript. Corresponding author Ethics declarations Disclosures Lanbo Zhao, Rong Cong, Zhenni Pan, Yan Xue, Yaling Li, and Qiling Li all have no conflicts of interest to disclose. Ethical approval This study was approved by the Ethic Committee of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2023LSYY-069) and was carried out in accordance with the Declaration of Helsinki. Informed consent Written informed consent was waived due to de-identified patients’ personal information in this study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Supplementary file1 (MP4 425709 KB) Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Zhao, L., Cong, R., Pan, Z. et al. The feasibility and short-term safety of single-site hysterectomy: a retrospective cohort study of a novel robotic platform. Surg Endosc 39, 1362–1371 (2025). https://doi.org/10.1007/s00464-025-11533-7 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00464-025-11533-7