title: Single-site robotic total hysterectomy: standardization of technique and surgical outcomes.
abstract: OBJECTIVE
  To evaluate the safety and feasibility of robotic single-site total hysterectomy and to compare the outcomes of newly implemented robotic single-site bipolar and external vessel-sealing device.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification II-1).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twenty-four patients with benign indications for hysterectomy.
  
  
  METHODS
  All patients underwent robotic-assisted single-incision transumbilical total hysterectomy using the novel da Vinci Single-Site Platform. Vaginal cuff closures were performed intracorporeally using the same technique in all cases.
  
  
  RESULTS
  The median age of the patients was 49.5 years (range, 40-61), and body mass index was 28.5 (range, 21-34). Blood loss was 22.5 mL (range, 7-120 mL). Docking time was 5.5 minutes (range, 3-10 minutes), console time was 74.5 minutes (range, 60-160 minutes), vaginal cuff closure time was 25 minutes (range, 16-41 minutes), and total operative time was 98.5 minutes (range, 71-183 minutes). When 2 groups were created according to the energy devices used during the procedures, console time in the newly implemented bipolar group was shorter than in the external sealing device group (69.5 minutes vs. 77 minutes; p = .03); however, no differences were found for uterus removal time (50.5 minutes vs. 53.5 minutes; p = .13). Differences were observed in vaginal cuff closure time (18.5 minutes vs 23 minutes; p = .01).
  
  
  CONCLUSIONS
  Robotic single-site total hysterectomy using a newly implemented bipolar grasping instrument and even with intracorporeal cuff closure is a safe and feasible procedure in appropriately selected patients.
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey. Electronic address: fatih.sendag@gmail.com.
authors: Fatih
authors: F
authors: Sendag
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Ali
authors: A
authors: Akdemir
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Burak
authors: B
authors: Zeybek
authors: Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.
authors: Asuman
authors: A
authors: Ozdemir
authors: Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.
authors: Ilkben
authors: I
authors: Gunusen
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Mehmet Kemal
authors: MK
authors: Oztekin
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013536:Suture Techniques; D014591:Uterine Diseases / Q000601:surgery*
keywords: Intracorporeal Suturing; Laparoendoscopic single-site surgery; Total hysterectomy; da Vinci Single-Site Platform