Abstract
Objective
To assess and compare the surgical outcomes of robotic-assisted single-site hysterectomy (SSH) and multi-site hysterectomy (MSH).
Design:
A retrospective cohort study from a single academic health care system.
Results
From October 2013 to June 2022, 127 SSH and 445 MSH were performed. 78% of SSH patients had a normal or overweight BMI compared to 49% of MSH patients (p < 0.001). 37% of SSH patients had a preoperative cancer diagnosis compared to 66% of MSH patients (p < 0.001). There were no differences in average number of prior abdominal surgeries (p = 0.6). The median operative time was 118 minutes for SSH compared to 162 minutes for MSH (p < 0.001). 23% of SSH patients were discharged on the day of surgery compared to 8% of MSH patients (p < 0.001). The plurality (47%) of SSH patients had a blood loss of < 50 mL compared to 50-100mL for the plurality (36%) of MSH patients (p < .001). 7% of patients undergoing MSH experienced major complications compared to only 2% of patients undergoing SSH (p = 0.025). Propensity score matched results using a 1:1 model were consistent with the overall analysis and prior findings, demonstrating statistically significant differences in median operative times, blood loss, and lengths of postoperative stay between SSH and MSH patients.
Conclusion
SSH has overall good outcomes, with this study demonstrating decreased operative times, decreased blood loss, lower rates of major complications, and shorter lengths of postoperative stay when compared to MSH. SSH may be an alternate surgical modality with utility in risk-reducing, precancerous, or early-stage cancer in gynecologic patients.