IMR Press / CEOG / Volume 50 / Issue 1 / DOI: 10.31083/j.ceog5001019
Open Access Systematic Review
“Less is More, is R-LESS More?”—The Use of Robotic Laparoendoscopic Single-Site Surgery in Gynaecology: A Scoping Review
Show Less
1 San Paolo bachelor school of Nursing, ASST Santi Paolo e Carlo, 20142 Milan, Italy
2 Department of Obstetrics and Gynecology, San Paolo Hospital Medical School, ASST Santi Paolo e Carlo, 20142 Milan, Italy
3 Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124 Parma, Italy
4 Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
*Correspondence: stefano.terzoni@unimi.it (Stefano Terzoni)
Academic Editors: Johannes Ott and Michael H. Dahan
Clin. Exp. Obstet. Gynecol. 2023, 50(1), 19; https://doi.org/10.31083/j.ceog5001019
Submitted: 22 July 2022 | Revised: 17 October 2022 | Accepted: 19 October 2022 | Published: 16 January 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Since the Da Vinci system was introduced in the gynaecological profession, for benign and most malignant procedures, it appeared that using 5 incisions for trocar insertion could jeopardize the system’s mini-invasiveness. To protect this important characteristic, robotic laparoendoscopic single-site surgery was developed and authorized for gynaecological use in 2013. Using a single small incision for the entire treatment appears to be a promising attempt to improve cosmetic results while lowering wound infections, postoperative pain, and recovery time. After nearly ten years of use, several limitations of this technique became apparent, such as a limited set of non-articulating instruments and electrical possibilities compared to multiport surgery, smoke evacuation and visual impairment. By examining the most relevant research, the goal of this review was to emphasize the indications, risks, and benefits of R-LESS in gynaecological surgery. Methods: A scoping review was conducted on Pubmed, Scopus, Web of Science, and Embase. Publications in English or Italian in the previous 10 years on the use of single-site robotic surgery in gynaecology for benign disorders were included. Results: This review includes 37 of the 297 papers that were retrieved. Myomectomy, hysterectomy, pelvic floor surgery, and endometriosis were the most common indications for single-site surgery. Several studies have reported R-LESS usage in cancer patients. According to the data analysis, the R-LESS approach is comparable to robotic multi-port surgery as regards feasibility and safety, with faster operative and postoperative durations, reduced pain, and a superior cosmetic outcome. Conclusions: The single-port robotic technique is gaining popularity. Our findings provide preliminary evidence of the global experience of surgical teams. Standardizing operative durations and conducting comparative research on the R-LESS learning curve represent one of the most significant future difficulties, as do surgical outcomes, costs, and patient satisfaction in the long run.

Keywords
single-site surgery
robotic surgery
review
Figures
Fig. 1.
Share
Back to top