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The robotic single-port platform for gynecologic surgery: a systematic review of the literature and meta-analysis

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Abstract

Since the first robotic single-site hysterectomy was performed, the research focused on the use of robotic single-site surgery (RSSS) for all gynecological conditions. This review aims to examine the studies available in the literature on RSSS in gynecology both for benign and malignant indications. The systematic review was carried out in agreement with the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA). All the articles were grouped into three sets based on the surgical indication (Group 1, 2, and 3 for benign, malignant, and mixed diseases, respectively). Two hundred and fifty total studies were analyzed, and 27 articles were included in the review. A total of 1065 patients were included in the analysis. Of these, 605 patients were included in group 1, 260 in group 2, and 200 in group 3. Ten (1.7%) patients with benign pathology, 16 (6.2%) patients with malignant disease, and 5 (2.5%) patients with both diseases developed major complications. Two (0.3%) patients in group 1, 3 (1.2%) patients in group 2 and 5 (2.5%) in group 3 were converted to a different type of surgery. No significant differences were found between groups for BMI (p = 0.235), operative time (p = 0.723), estimated blood loss (EBL) (p = 0.342), and hospital stay (p = 0.146). The complications and conversions incidence through pooled analysis showed a higher general conversion rate (p = 0.012) in group 3 (3.0%) and higher complications rate (p = 0.001) in group 2 (5.3%) compared to the other groups. RSSS seems to be a feasible and safe procedure for all gynecological surgical procedures. A long-term analysis would be necessary before considering the RSSS oncologically safe for patients with malignant disease.

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Funding

The work was not supported by any fund/grant.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics of Parma, University of Parma, via Gramsci, 14, 43125, Parma, Italy

    Vito Andrea Capozzi & Giulia Armano

  2. Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Andrea Rosati

  3. Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti E Terapie Ad Alta Specializzazione), University of Pittsburgh Medical Center Italy, Palermo, Italy

    Alessandro Tropea

  4. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

    Antonio Biondi

Authors
  1. Vito Andrea Capozzi
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  2. Giulia Armano
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  3. Andrea Rosati
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  4. Alessandro Tropea
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  5. Antonio Biondi
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Corresponding author

Correspondence to Vito Andrea Capozzi.

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Capozzi, V.A., Armano, G., Rosati, A. et al. The robotic single-port platform for gynecologic surgery: a systematic review of the literature and meta-analysis. Updates Surg 73, 1155–1167 (2021). https://doi.org/10.1007/s13304-020-00812-8

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  • DOI: https://doi.org/10.1007/s13304-020-00812-8

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