Comparison of Surgical Outcomes Between Single-Port Access Laparoscopic and Single-Site Robotic Surgery in Benign Gynecologic Diseases: A Single-Center Cohort Study

Background/Objectives: To compare the outcomes of single-port access laparoscopic surgery (SPALS) and single-site robotic surgery (SSRS) for benign gynecological diseases, we retrospectively analyzed clinical data from 367 patients who underwent gynecologic surgery at Sejong Chungnam National University Hospital from October 2020 to December 2023. Methods: Of these 367 patients, 197 underwent SPALS, whereas 170 underwent SSRS. The SPALS group comprised 87 patients who underwent hysterectomy; 107, adnexal surgery (cystectomy: 44, adnexectomy: 63); and 1 myomectomy. The SSRS group included 68 patients who underwent myomectomy; 61, adnexal surgery (cystectomy: 52, adnexectomy: 9); 35, hysterectomy, and 4, sacrocolpopexy. Results: Both surgical techniques were successful, with no patients requiring open surgery. No significant differences were observed in the baseline characteristics between the two groups. Compared with the SPALS group, the SSRS group had a younger age (39.8 +/- 9.5 vs. 44.5 +/- 12.3 years, p = 0.001). Severe intra-abdominal adhesions were more frequently observed in the SSRS group (p = 0.004). Operation time (118.1 +/- 65.9 vs. 57.1 +/- 27.3 min, p = 0.001), gas passing time (39.4 +/- 15.37 vs. 30.4 +/- 13.5 h, p = 0.001), and hospital length of stay (4.26 +/- 1.02 vs. 4.02 +/- 0.8 days, p = 0.012) were significantly longer in the SSRS group. However, no significant differences were found between the two groups in terms of intraoperative blood loss, intraoperative complications, or readmission rates. Conclusions: SSRS offers a feasible and promising approach for treating gynecological benign diseases. Younger and lower-parity patients tend to undergo SSRS rather than SPALS, with SSRS primarily performed for myomectomy and complex adnexal surgery. However, operation time and gas passing time were significantly longer in the SSRS group.