Comparative surgical outcomes of single port SP1098 vs multiport Xi platforms for benign hysterectomy using the...

There is limited published data evaluating the safety of the da-Vinci-SP1098 platform and only a few utilize the Clavien-Dindo Classification (CDC). Comprehensive complication index (CCI) is developed to overcome the restrictions of the CDC. We aimed to compare the perioperative outcomes of hysterectomy for benign disease with the da-Vinci-SP1098 platform (SPORT-SP-H) with the multiport-XI-hysterectomy (MP-Xi-H).

We conducted a retrospective cohort study incorporating a total of 96 patients at a tertiary academic center. Parameters included demographic features, Charlson comorbidity index, Surgical APGAR, indications, and concurrent procedures. Perioperative outcomes included CCI score, CDC grade, length of operation, estimated blood loss, intraoperative complications, length of stay, and conversion rate, sequelae, failure to cure, reoperation and emergency department visit within 1 month. Univariate and multivariate analysis for CCI, CDC and operation duration was undertaken.

Demographic factors were similar. Charlson's comorbidity index (B = 1.43, 95% CI 0.17-2.6, p = 0.02) was found to be the only independent predictor of CCI in the multivariate analysis. There were no grade IV or higher CDC postoperative complications. Except CDC grade I, all were similar between the cohorts. Operation time was significantly longer in SPORT-SP-H (178, r 85-258) compared to MP-Xi-H (123.5, r 74-218, p < 0.0001). Length of hospital stay and other parameters were comparable between the groups (p > 0.05). Independent predictors of longer operation time were SPORT-SP-H, uterine weight and concurrent procedures.

SPORT-SP-Hysterectomy (SP1098) appears to be an alternative to multiport robotic hysterectomy but with a longer operating time. Morbidity is related to surgical complexity and patient comorbidities rather than the robotic platform.