Robotic single-site hysterectomy (RSS-H) vs. laparoendoscopic single-site hysterectomy (LESS-H) in early endometrial cancer: A double-institution case-control study

- LESS has some technical limits.
- The combination of robotic surgery in a single incision may facilitate LESS.
- The robotic platform does not improve the peri-operative performances of LESS.

ObjectiveTo report our experience with single-site robotic platform for IS3000 “Da Vinci” Si Surgical System to perform robotic single site hysterectomy (RSS-H), and to compare peri-operative results with a historical series of laparoendoscopic single site hysterectomies (LESS-H).MethodsThis is a retrospective case-control study, performed at the Gynecologic Oncologic Unit, National Cancer Institute “Regina Elena”, Rome, and at the Gynecologic Oncologic Unit, Catholic University of the Sacred Heart, Rome, Italy between December 2011 and January 2013.Results19 women underwent RSS-H (cases) and 38 patients were submitted to LESS-H (controls) for early endometrial cancer. Pre-surgical procedures (port placement and docking) required a median time of 8 min in the RSS-H group and a median time of 2 min in the LESS-H group (p = 0.0001). The median estimated blood loss was 75 ml in the cases and 30 ml in the controls (p = 0.005). The median operative time, calculated from the beginning of intraperitoneal procedures to the skin closure, was 90 min in the cases and 107 ml in the controls (p = ns). The median time to discharge from the hospital was postoperative day two for both techniques.ConclusionsThe few differences we registered do not seem clinically relevant, thus making the two procedures comparable.