Comparison between single-site and multiport robot-assisted hysterectomy in obese patients with endometrial cancer: An Italian multi-institutional study

Int J Med Robot. 2020 Apr;16(2):e2066. doi: 10.1002/rcs.2066. Epub 2019 Dec 29.


Background: The aim of this study is to compare robotic single-site hysterectomy (RSSH) and robotic multiport hysterectomy (RMPH) for endometrial cancer (EC) in obese patients in terms of surgical outcomes.

Methods: This retrospective study compares RSSH with RMPH in obese patients with EC and FIGO stages I to II divided in three classes according to their body mass index (BMI): class A (30-34.9 kg/m2 ), class B (35-39.9 kg/m2 ), and class C (>40 kg/m2 ).

Results: We included 225 patients (RSSH: 76; RMPH: 149). The operative time and estimated blood loss (EBL) were lower in the A class of the RSSH group. The EBL and the conversion rate increased when the BMI increased in the RSSH group. The hospital stay was higher in the A class of the RMPH group.

Conclusions: The advantages of RSSH in terms of reduced invasiveness remain true only in the first BMI class, whereas they are lost when the BMI increased.

Keywords: endometrial cancer; obesity; robotic multiport hysterectomy; robotic single-site hysterectomy.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Case-Control Studies
  • Endometrial Neoplasms / complications
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Hysterectomy / instrumentation*
  • Hysterectomy / methods
  • Italy / epidemiology
  • Laparoscopy
  • Length of Stay
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / surgery*
  • Operative Time
  • Research Design
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*