Emerging robotic platforms in gynecologic surgery: a systematic review

Robotic innovation in gynecologic surgery has expanded beyond established multiport ecosystems toward single-port, modular multi-arm, transvaginal, AI-enabled, and teleoperated platforms. However, available evidence remains fragmented and unsuitable for quantitative synthesis. This systematic review evaluated emerging robotic platforms in gynecologic surgery, focusing on procedure types, outcomes, costs, and learning curves. The review was prospectively registered in PROSPERO (CRD420261360389). Eligible studies included clinical studies evaluating emerging robotic platforms in gynecologic surgery. PubMed, Scopus, and Web of Science were searched on 4 April 2026. After duplicate removal, 408 records were screened, 160 full texts assessed, and 92 studies included. Data extraction and risk of bias assessment were performed independently in duplicate. The 92 studies covered 13 platforms and were mainly retrospective single-center studies. Evidence was most extensive for da Vinci SP and HUGO RAS, with more limited but informative data for Senhance, Versius, hinotori, and KANGDUO. Evidence for other systems consisted mainly of first-in-human, pilot, or feasibility studies. Hysterectomy and sacrocolpopexy were the most frequently reported procedures. Overall, perioperative outcomes and short-term safety appeared favorable, despite limited follow-up and heterogeneous outcome definitions. Cost data were mainly available for Senhance and KANGDUO. Learning-curve evidence was strongest for da Vinci SP and HUGO RAS. Risk-of-bias was predominantly moderate. Emerging robotic platforms have demonstrated broad technical feasibility and generally acceptable short-term perioperative safety in selected gynecologic procedures, but current evidence is heterogeneous, observational, and methodologically limited. Rigorous prospective studies, standardized economic analyses, longer follow-up, and learning-curve evaluations are needed before comparative conclusions can be drawn.