Robotic Surgeries in Benign Gynaecological Conditions: Experience in Our Institution

Gynaecological robotic surgery is one of the latest transformations in minimally invasive operative techniques. Gynaecological surgeons treat several conditions that affect a woman's reproductive organs using miniature instruments guided through a robotic system. Currently, benign gynaecological surgeries do not have many remarkable advantages over conventional laparoscopic surgeries. EndoWrist manoeuvres of robotic instruments resemble the open surgical technique, which allows better and precise suturing than conventional laparoscopy in procedures like myomectomy and sacrocolpopexies. Our study showcases our adaptation to the newest innovation and its outcome.

Our prospective study includes 30 benign gynaecological cases operated by single surgeon in Da Vinci Xi system from June 2023 to July 2024. This included 28 hysterectomies and 2 myomectomies. Baseline demographic data, docking time, console time, blood loss, post-operative pain and dosage of analgesia taken, post-op ambulation, length of hospital stay, and post-op complications have been assessed.

The BMI of 30-34.9 kg/m² contributed to 24%, and 35-39.9 kg/m² contributed to 21%. Docking time reduced from around 45 ± 15 min to 15 ± 5 min. An average console time was 132 min, which stepped down from 216 min. The average blood loss in 50% of them is 50-100 ml. A 95% of patients were discharged between 3 and 5 days. Post-operatively, 35% had mild pain and 50% moderate pain, assessed by the VAS scale.

A minimally invasive technique with outcomes similar to laparoscopy but with an EndoWrist movement aiding to a less steeper learning curve to the surgeons and patient friendly outcomes which enhance with expertise.