Comparison of Single-port Robotic Surgery Using the Da Vinci SP Surgical System and Single-port Laparoscopic Surgery for Benign Indications.

Objectives: Robot-assisted surgery has become popular in Japan, especially with the introduction of the da Vinci SP^® surgical system, which is a significant advancement in minimally invasive surgery. The da Vinci SP^® surgical system, which enables single-port surgery, has recently been developed. This study aims to compare the surgical outcomes of conventional single-port laparoscopic surgery and single-port robotic surgery using the da Vinci SP surgical system.

Materials and methods: We included 23 patients who underwent single-port robot-assisted total hysterectomy (SP-RAH) for uterine fibroids and 33 patients who underwent conventional single-port total laparoscopic hysterectomy (SP-TLH). Surgical outcomes from the 1^st year after the introduction of the da Vinci SP^® system were compared between the two techniques.

Results: Surgical outcomes showed the following differences between the SP-RAH and SP-TLH groups: Weights of the resected uterus: 217 (90-500) g versus 256 (100-436) g (P = 0.06); intraoperative blood loss: 12 (4-147) mL versus 80 (10-780) mL (P < 0.01); total surgery duration: 199 (131-251) min versus 239 (110-282) min (P < 0.03); pneumoperitoneal surgery duration: 146 (90-221) min versus 186 (110-282) min (P = 0.03). SP-RAH showed significantly less blood loss and shorter operative durations.

Conclusion: The da Vinci SP system allows the safe introduction of single-port total hysterectomy and improves surgical outcomes in the early stages compared to conventional single-port laparoscopy. Future studies may expand its use to improve wound alignment and reduce patient burden.