Single-port robotic surgery in gynecologic oncology: feasibility and safety after 1 year of implementation.

OBJECTIVE

Single-port robotic surgery is an emerging technology in Europe, offering potential advantages for minimally invasive gynecologic procedures. However, its application in gynecologic oncology remains limited, and evidence regarding its feasibility, safety, and technical challenges is scarce. This study aimed to prospectively evaluate the feasibility and safety of single-port robotic surgery in gynecologic oncology within a high-volume referral center.

METHODS

We conducted a prospective cohort study of all consecutive patients who underwent a single-port robotic approach for suspected or confirmed gynecologic cancer at the European Institute of Oncology, Milan, between July 2024 and June 2025. Surgical procedures were performed by a dedicated gynecologic oncology team following international guidelines. Patient demographics, intra-operative characteristics, and post-operative outcomes were prospectively collected.

RESULTS

A total of 63 patients were included, with a median age of 57 years (inter-quartile range, [IQR]; 46-65) and a median body mass index of 24.4 kg/m2 (IQR; 22.0-27.3). Endometrial cancer was the most common indication (47.6%). All procedures were completed without conversion to multi-port or open surgery. Median operative time was 131 minutes (IQR; 105-155), and median estimated blood loss was 50 mL (IQR; 30-100). No intra-operative complications occurred. Post-operative pain was minimal, with median Numerical Rating Scale scores of 1 at all assessed time points. The median hospital stay was 2 days (IQR; 2-2). Three major post-operative complications occurred within 30 days (4.8%), all managed surgically: 2 pelvic hematomas and 1 pelvic abscess.

CONCLUSIONS

Single-port robotic surgery appears feasible and safe for selected patients with gynecologic malignancies, with no conversions and no intra-operative complications. However, larger, multi-institutional studies with longer follow-up are needed to confirm oncologic safety and define its role in practice.