Clinical advantages of robot-assisted transvaginal natural orifice transluminal endoscopic surgery total hysterectomy:a retrospective cohort study
10.16781/j.CN31-2187/R.20250432
- VernacularTitle:机器人辅助经阴道自然腔道腹腔镜全子宫切除术的临床优势:回顾性队列研究
- Author:
Jiahui ZHAO
1
;
Yuan LIAO
;
Jüyuan HUANG
;
Jiaqiang XIONG
;
Manwen LUO
;
Wei ZHANG
Author Information
1. 武汉大学第二临床学院,武汉 430071
- Keywords:
robot-assisted transvaginal natural orifice transluminal endoscopic surgery total hysterectomy;
transvaginal natural orifice transluminal endoscopic surgery total hysterectomy;
robot-assisted laparoendoscopic single-site total hysterectomy;
minimally in
- From:
Academic Journal of Naval Medical University
2025;46(11):1407-1413
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically compare the perioperative outcomes of robot-assisted transvaginal natural orifice transluminal endoscopic surgery total hysterectomy(R-vNOTES-TH),transvaginal natural orifice transluminal endoscopic surgery total hysterectomy(vNOTES-TH),and robot-assisted laparoendoscopic single-site total hysterectomy(R-LESS-TH),and to evaluate the clinical advantages of R-vNOTES-TH.Methods Clinical data of 259 patients undergoing total hysterectomy for benign diseases at Zhongnan Hospital of Wuhan University from Jan.2020 to Dec.2024 were retrospectively analyzed.Baseline indicators and perioperative indicators were collected.Patients were assigned to 3 groups according to the surgical approach:R-vNOTES-TH group(n=22),vNOTES-TH group(n=39),or R-LESS-TH group(n=198).Perioperative indicators were compared between the R-vNOTES-TH group and the other 2 groups to evaluate the advantages of R-vNOTES-TH.Results Compared with the vNOTES-TH group,the R-vNOTES-TH group had significantly less intraoperative blood loss(50[50,100]mL vs 100[50,100]mL,P=0.027),lower intraoperative fluid infusion volume(1 000[500,1 000]mL vs 1 000[1 000,1 500]mL,P＜0.001),and shorter urinary catheter indwelling time(3[1,4]d vs 5[2,5]d,P=0.043),but longer vaginal drain indwelling time(2[2,3]d vs 2[0,2]d,P=0.004).Compared with the R-LESS-TH group,the R-vNOTES-TH group had longer urinary catheter indwelling time(3[1,4]d vs 1[1,1]d,P＜0.001).Conclusion Compared with vNOTES-TH,R-vNOTES-TH enhances intraoperative operational precision,reduces bleed loss,and accelerates urinary catheter removal,confirming that the robotic system effectively overcomes the technical limitations of conventional vNOTES.Although R-vNOTES-TH eliminates abdominal wall trauma-thereby prolonging urinary catheter indwelling time relative to R-LESS-TH-it offers patients a truly scar-free alternative.
