title: Robotic single-site versus laparoendoscopic single-site hysterectomy: a propensity score matching study.
abstract: BACKGROUND
  The aim of this study was to compare the surgical outcomes of robotic single-site (RSS-H) and laparoendoscopic single-site total hysterectomy (LESS-H) and to evaluate the feasibility of RSS-H in patients with benign gynecologic disease.
  
  
  METHODS
  The RSS-H was performed using the da Vinci single-site surgical platform, and the LESS-H using a single multi-channel port system at the umbilicus. Among 467 consecutive patients who had undergone total hysterectomy for benign gynecologic disease, surgical outcomes were compared between RSS-H group (n = 25) and LESS-H group (n = 442) after propensity score matching.
  
  
  RESULTS
  All operations were completed robotically and laparoscopically without conversion to laparotomy, respectively. The RSS-H group had longer operating times and less operative bleeding compared to the LESS-H group. While the LESS-H showed 1.4% of major complication rate, the RSS-H had no perioperative complication. Even after propensity score matching, the RSS-H still showed longer operating times (170.9 vs 94.1 min, p < 0.0001) and less operative bleeding (median estimated blood loss, 20 vs 50 ml, p = 0.009; mean hemoglobin drop, 1.6 vs 2.0 g/dl, p = 0.038) than the LESS-H.
  
  
  CONCLUSIONS
  The RSS-H could be a feasible and safe procedure in appropriately selected patients with benign gynecologic disease, and further experience and technical refinements will continue to improve operative results. Prospective randomized trials will permit the evaluation of the potential benefits of the RSS surgery as a minimally invasive surgical approach.
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea. paek.md@gmail.com.
authors.forename: Jiheum
authors.identifier: http://orcid.org/0000-0003-3964-5925
authors.initials: J
authors.lastname: Paek
authors.affiliation: Office of Biostatistics, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jung-Dong
authors.initials: JD
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea.
authors.forename: Tae Wook
authors.initials: TW
authors.lastname: Kong
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea.
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea. hsryu@aumc.ac.kr.
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D057216:Propensity Score; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery*
keywords: Hysterectomy; Laparoscopy; Robotics