{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:30:19Z","timestamp":1787725819432,"version":"build-2784847793"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"CHU Saint-\u00c9tienne"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vaginal hysterectomy is the preferred approach when feasible, but technical limitations may restrict its use in complex cases. Robotic assistance combined with vaginal natural orifice transluminal endoscopic surgery (vNOTES) aims to overcome these limitations. The da Vinci\u00ae Single-Port (SP) system, designed for narrow spaces, may further optimize robotic-assisted vaginal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, single-center case series including all robotic-assisted vaginal hysterectomies performed using the da Vinci\u00ae SP system (RSP-vNOTES) between October 2024 and April 2026. Clinical, perioperative, and postoperative data were collected from medical records. Outcomes were analyzed using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen RSP-vNOTES hysterectomies were performed by two experienced surgeons. Median total operative time was 74\u00a0min (60.8, 96.8). The main surgical indication was uterine fibroids with large uterine volume; median uterine weight was 370\u00a0g (61, 800). Estimated blood loss was minimal, with no conversions or intraoperative complications. Sixteen patients (94.1%) underwent same-day discharge; one patient required one night hospitalization due to anesthetic contraindications related to comorbidities. Postoperative pain was low, with a median VAS score of 0 at 4\u00a0h (0\u20131). No postoperative complications were observed within 30\u00a0days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic-assisted vaginal hysterectomy using the da Vinci\u00ae Single-Port system is feasible and safe, with favorable short-term outcomes, including in cases with large uterine volume. Direct intravaginal insertion of the SP access port provides effective robotic assistance in a confined anatomical space. Larger prospective studies are needed to confirm these findings and further define the role of single-port robotic technology in vaginal gynecologic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12883-6","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:21:08Z","timestamp":1778617268000},"page":"5379-5386","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robotic single-port (SP) vaginal hysterectomy: the first cases in Europe and surgical steps"],"prefix":"10.1007","volume":"40","author":[{"given":"Layanna","family":"Otrante","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3015-7610","authenticated-orcid":false,"given":"Louise","family":"Moniod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Rousseau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-8133","authenticated-orcid":false,"given":"Celine","family":"Chauleur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"12883_CR1","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.ejogrb.2009.10.019","volume":"148","author":"J Drahonovsky","year":"2010","unstructured":"Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J (2010) A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease. 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Louise Moniod and Clement Rousseau received training supported by Intuitive Surgical. Celine Chauleur received honorary from Intuitive Surgical. Intuitive Surgical was not involved in the conduct of the study or the preparation of the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}