2025 Volume 41 Issue 1 Pages 71-78
Objective: To evaluate the surgical outcomes and safety of robot-assisted hysterectomy during the first five years of its practice, we investigated the details and perioperative complications.
Methods: We retrospectively analyzed the cases of robot-assisted hysterectomy performed from March 2018 to March 2023.
Results: We extracted 128 cases (102 benign diseases, 26 malignancies). Based on a cumulative sum analysis of the operation duration, one surgeon exhibited a bimodal pattern with peaks at the 8th and 47th cases, while another showed a peak at the 24th case. The resurgence in the bimodal pattern between the 24th and 25th cases coincided with a six-month period of surgical restrictions. Although the uterus weight tended to increase, blood loss decreased after the 25th case. There was one (0.8%) intraoperative complication, of bladder wall injury during transvaginal uterine morcellation. Eight cases (6.3%) with fibroids and/or adenomyosis had blood loss of 500 mL or more. Their median uterus weight was 494 g, approximately twice that of all benign cases. Postoperative complications occurred in five cases (3.9%): two pelvic infections, one wound infection, and two incidents of vaginal cuff dehiscence. Patients had risk factors such as sexual intercourse, 11th case, and history of chemotherapy in cases of dehiscence.
Conclusions: Robot-assisted hysterectomy has been performed safely for the first five years. The interval between surgeries influenced the operation duration. Although cases with higher uterus weight tended to have higher blood loss, this relative incidence is expected to decrease with an increasing number of cases. It is necessary to assess risks on individual cases to reduce perioperative complications.
