Single Port Versus Multiport Robotic Hysterectomy With Sacrocolpopexy

Literature comparing single port (SP) robotic surgery to the traditional multiport (TMP) robotic approach is limited.

The objective of this study was to determine differences in postoperative pain following SP versus TMP robotic hysterectomy with concomitant sacrocolpopexy.

We performed a retrospective cohort study at a single tertiary care center between December 2021 and February 2023 of women undergoing SP and TMP robotic hysterectomy with concomitant sacrocolpopexy for prolapse. The primary objective was to identify differences in postoperative pain within the postanesthesia care unit (PACU) and on POD1. A 0-10-point pain visual analogue scale was utilized to determine participants' pain. Surgical outcomes, adverse events, and recurrent prolapse were analyzed as secondary objectives. Recurrent prolapse was defined as new bothersome vaginal bulge symptoms, evidence of prolapse beyond the hymen at postoperative examination, or retreatment for prolapse.

One hundred thirty-four women underwent robotic hysterectomy with sacrocolpopexy: 66 (49.3%) on SP and 68 (50.7%) on TMP robotic platforms. Participants in the SP cohort were younger ( P = 0.03) with a lower body mass index ( P = 0.002). Pain scores were low across the cohort, but median (range) PACU pain scores were lower in the SP cohort ( P < 0.001) compared with TMP cohort. There were no differences in pain scores at the postoperative visits. On linear regression, SP robotic hysterectomy with concomitant sacrocolpopexy was associated with lower PACU pain scores ( P < 0.001).

SP robotic surgery offers improved immediate postoperative pain control compared with the TMP robotic approach following hysterectomy with concomitant sacrocolpopexy.