Primary study on robotic single-site laparoscopy in gynecological surgery

Xiaohui Lyu; Xin Guo; Jia Li; Lingxia Li; Hong Yang; Wei Zou; Jian Wang; Biliang Chen; Wei Zhang; Shujuan Liu

doi:10.3877/cma.j.issn.1674-6899.2019.03.007

Primary study on robotic single-site laparoscopy in gynecological surgery

Xiaohui Lyu, Xin Guo, Jia Li, Lingxia Li, Hong Yang, Wei Zou, Jian Wang, Biliang Chen, Wei Zhang, Shujuan Liu

In: Chin J Laparoscopic Surgery(Electronic Edition) · 2019 · vol. 12(3) , pp. 154–158 · doi:10.3877/cma.j.issn.1674-6899.2019.03.007 · W3032811315

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Robotic single-site laparoscopy was safely and effectively performed in seven gynecological surgery patients, with all procedures completed successfully and favorable perioperative outcomes.

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This retrospective study evaluated the safety and feasibility of robotic single-site laparoscopy in gynecological surgery using perioperative data from 7 patients treated between January and December 2018 at a single institution. The authors recorded age, BMI, operative time, blood loss, hemoglobin change, intra- and postoperative complications, time to bowel movement, 24-hour postoperative pain (VAS), hospital stay, and 1-month follow-up outcomes. All 7 procedures were completed successfully, with a median operative time of 141 minutes, median blood loss of 86 mL, and low 24-hour pain scores (VAS 1–3), and the paper reports good healing of the umbilical incision and vaginal stump at 1 month. The study limitation explicitly noted in the text is the small sample size and need for more practical and clinical research to verify conclusions. Relevance to endometriosis: adenomyosis (one case included alongside a DIE excision) is directly discussed as an indication for the robotic single-site procedure, though the paper’s main topic is robotic single-site laparoscopy feasibility across gynecologic indications.

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Abstract

Objective To investigate the safety and feasibility of robotic single-site laparoscopy in gynecological surgery. Methods Clinical data of seven patients undergoing robotic single-site laparoscopic gynecological surgery in the department of obstetrics and gynecology of the First Affiliated Hospital of Air Force Military Medical University from Jan. to Dec. 2018 were retrospectively analyzed to analyze its clinical efficacy. The perioperative data was analyzed as follows: age, BMI, operative time, blood loss, postoperative VAS pain score, time for bowel movement, and hospital stay. Measurement data was presented as mean standard deviation. Results All the 7 patients successfully completed the operation, among which 4 patients received robotic single-site laparoscopic surgery with fascia platform and 3 patients with LAGIPORT. Among the patients, 6 cases was diagnosed as endometrial carcinoma which underwent bilateral hysterectomy and pelvic lymph node dissection, and 1 case underwent hysterectomy and DIE dissection for adenomyosis combined with sacral ligament. The median age of the patients was 45 years old (35-57 years old ), the body mass index was 22.9 kg/m2 (20.5-25.4 kg/m2), the median operative time was 141 min (115-170 min), the median intraoperative blood loss was 86 ml(50-200 ml), the hemoglobin difference before and after the operation was 6 g/L (5-10 g/L), the median postoperative hospital stay was 5 d(4-6 d), the postoperative intestinal function recovery time was 16.5 h(12-22 h), and the pain score was 1.7 (1-3 points) at 24 h after the operation. Umbilical wound and vaginal stump healed well in all patients after one month. Conclusions Robotic single-port laparoscopy can be used safely and effectively in gynecological surgery, but more practical and clinical studies are needed to verify it. Key words: Robotic surgery; Single-site laparoscopic; Endometrial carcinoma; Endometriosis

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Objective

To investigate the safety and feasibility of robotic single-site laparoscopy in gynecological surgery.

Methods

Clinical data of seven patients undergoing robotic single-site laparoscopic gynecological surgery in the department of obstetrics and gynecology of the First Affiliated Hospital of Air Force Military Medical University from Jan. to Dec. 2018 were retrospectively analyzed to analyze its clinical efficacy. The perioperative data was analyzed as follows: age, BMI, operative time, blood loss, postoperative VAS pain score, time for bowel movement, and hospital stay. Measurement data was presented as mean standard deviation.

Results

All the 7 patients successfully completed the operation, among which 4 patients received robotic single-site laparoscopic surgery with fascia platform and 3 patients with LAGIPORT. Among the patients, 6 cases was diagnosed as endometrial carcinoma which underwent bilateral hysterectomy and pelvic lymph node dissection, and 1 case underwent hysterectomy and DIE dissection for adenomyosis combined with sacral ligament. The median age of the patients was 45 years old (35-57 years old ), the body mass index was 22.9 kg/m2 (20.5-25.4 kg/m2), the median operative time was 141 min (115-170 min), the median intraoperative blood loss was 86 ml(50-200 ml), the hemoglobin difference before and after the operation was 6 g/L (5-10 g/L), the median postoperative hospital stay was 5 d(4-6 d), the postoperative intestinal function recovery time was 16.5 h(12-22 h), and the pain score was 1.7 (1-3 points) at 24 h after the operation. Umbilical wound and vaginal stump healed well in all patients after one month.

Conclusions

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