Implementing Robotic Gynecologic Surgery: Early Outcomes From a Tertiary Care Hospital in Portugal

Introduction Robotic surgery is increasingly used in minimally invasive gynecologic procedures. In Portugal, its integration into the National Health Service is still recent. This study presents the early clinical experience of a Portuguese tertiary center with robot-assisted gynecologic surgery. Materials and methods This was a retrospective, observational, and descriptive study based on the analysis of clinical charts from patients who underwent robot-assisted gynecologic surgery between October 2022 and December 2024. Demographic, intraoperative, and postoperative variables were evaluated, as well as histopathological results. Results A total of 109 patients underwent robot-assisted gynecologic surgery during the study period. The median patient age was 55 years, and the median BMI was 26.6 kg/m². The main surgical indication was adnexal tumor in 46 patients (42.2%), followed by endometrial tumor or its precursors in 33 patients (30.3%). The most commonly performed procedure was total hysterectomy (69.7%). The median operative time was 193 minutes, and estimated blood loss was less than 100 mL in most cases (66.1%). The conversion rate to laparotomy was 0.9%, and the median length of hospital stay was one day. Complications occurred in 10.1% of patients, most of which were Clavien-Dindo grade I or II. The readmission rate was 2.8%. Conclusion The implementation of robotic-assisted gynecologic surgery in our center was associated with favorable short-term outcomes, including low complication and readmission rates, minimal blood loss, and rapid recovery. While limited to a single-center experience, this study adds to the growing evidence on the safe and feasible introduction of robotic surgery in gynecologic practice.