A new surgical technique for robotic hysterectomy using the da Vinci SP^® system

This is the first report to describe a novel surgical technique for single-port (SP) hysterectomy performed through a mini-Pfannenstiel incision using the da Vinci SP^® surgical system (Intuitive Surgical, Sunnyvale, CA). Hysterectomy was performed using the SP surgical system. A 2.7 cm mini-Pfannenstiel incision was created, through which a wound retractor (Intuitive Surgical, Sunnyvale, CA) was inserted. The access port of the da Vinci SP^® system (Intuitive Surgical, Sunnyvale, CA) was then connected. Side docking of the da Vinci SP^® system was performed on the patient's left side. No additional ports were inserted. Following docking, the procedure was conducted from the surgeon's console. The surgical steps for Hysterectomy were as follows: (1) incision of the broad ligament; (2) bladder dissection; (3) incision of the cardinal ligament; (4) incision of the vagina; and (5) vaginal cuff closure. The hysterectomy was completed without complications. Total operative time was 90 min, with an estimated intraoperative blood loss of 5 ml. The median surgical time for previous transumbilical hysterectomies performed by the same surgeon was 94 min, indicating comparable duration. This technique demonstrates the feasibility performing robotic hysterectomy using the da Vinci SP^® system through a mini-Pfannenstiel incision. Further evaluation in clinical settings is warranted.