Journal of Robotic Surgery

, Volume 12, Issue 2, pp 201–213 | Cite as

Single-site port robotic-assisted hysterectomy: an update

  • Christos Iavazzo
  • Evelyn Eleni Minis
  • Ioannis D. Gkegkes
Review Article


Single-incision approach in robotic gynecology is a relatively new concept. The role of single-port systems in robotic hysterectomy, their advantages and disadvantages, as well as the technical challenges, are still under investigation. A systematic review was performed by searching in PubMed and Scopus databases. In 810 out of 1225 patients, hysterectomy was performed for non-neoplastic disease. Single-Site® was the most common port system. Duration of the procedure and relative blood loss ranged from 60 to 311 min and 7 to 750 ml, respectively. The weight of the removed uteri ranged from 39 to 520 g. 4.9% of the included patients presented complications, among which bleeding, vaginal haematoma, laceration and dehiscence, umbilical hernia, and visceral injuries. Conversion rate to laparotomy reached 2.8%. Although some technical difficulties are still described in the literature, the single-port approach is becoming more standardized nowadays and performed by more surgeons. The initial phase of the learning curve can be achieved after five cases, while a proficiency in intracorporeal cuff suturing after 14 cases. Uterus weight and previous abdominal surgical history can still be limitations of the technique. Compared to our previous study, we can see that the technique has been used in more elderly or obese patients. The complication rate can reach 4.9% while the conversion rate can reach 2.8%. However, we consider that complication and conversion rates as well as surgical time could be improved with experience. Regarding post-operative pain and cosmetic outcomes, the lack of information do not allow us to draw any safe conclusions.


Single port Laparoendoscopic single site Single incision Robotics Hysterectomy Update 


Compliance with ethical standards

Conflict of interest

Christos Iavazzo has no conflicts of interest or financial ties to disclose. Evelyn Eleni Minis has no conflicts of interest or financial ties to disclose. Ioannis D. Gkegkes has no conflicts of interest or financial ties to disclose.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not applicable.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Christos Iavazzo
    • 1
    • 3
  • Evelyn Eleni Minis
    • 2
  • Ioannis D. Gkegkes
    • 2
  1. 1.Gynaecological Oncology DepartmentNorthampton General HospitalNorthamptonUK
  2. 2.First Department of SurgeryGeneral Hospital of Attica “KAT”AthensGreece
  3. 3.Nea Ionia, AthensGreece

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