The feasibility and surgical outcomes of robotic vaginal natural orifice transluminal endoscopic single port hysterectomy for benign gynecologic diseases: a systematic review and meta-analysis

Abstract

Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) combines vaginal surgery with single-port laparoscopy, providing a minimally invasive technique designed to overcome the challenges in traditional vaginal surgery. Several authors have now described techniques for performing these procedures with robotic assistance (R-vNOTES). We aim to evaluate the surgical outcomes and the safety of R-vNOTES hysterectomy in patients with benign diseases. Data Sources: We searched six major databases from their inception through October 2024 for studies analyzing the surgical outcomes of hysterectomy by R-vNOTES in cases with benign gynecologic diseases. Study eligibility criteria: We included all primary research studies that included at least one of our selected outcomes and did not include surgeries for malignant conditions. Study appraisal and synthesis methods: Study quality was appraised using the National Heart, Lung, and Blood Institute quality assessment tools. Data synthesis was accomplished using OpenMetaAnalyst and RevMan software. Mean difference and 95% confidence intervals were used for continuous outcomes following inverse variance analyses. Dichotomous outcomes were analyzed using an odds ratio and 95% confidence intervals. Results: =.98). Conclusion: Initial data shows that R-vNOTES seems to be a feasible minimally invasive technique with comparable outcomes and a favorable safety profile. Compared to RALH, R-vNOTES was associated with a shorter operation time and less blood loss.