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The DEXTER\u00ae Robotic Surgery System was developed to address the limitations of conventional robotic systems, offering a mobile, modular, and accessible alternative adaptable to various surgical environments. This prospective, multicenter, single-arm study evaluated the clinical performance and early postoperative safety of the robotic-assisted hysterectomy with adnexal surgery for benign indications with DEXTER. The primary endpoints were short-term safety, assessed by the occurrence of Clavien\u2013Dindo grade\u00a0\u2265\u00a0III adverse events up to 42\u00a0days postoperatively, and procedural success without conversion to laparoscopy or open surgery. Fifty-two patients were enrolled across four European centers\u2014one university hospital and three community hospitals. All procedures were successfully completed without intraoperative complications or conversions. The mean total skin-to-skin operative time was 121.9\u2009\u00b1\u200942.7\u00a0min, and the mean estimated blood loss was 87.8\u2009\u00b1\u200993.8\u00a0mL. The system also demonstrated efficient setup with a mean docking time of 3.8\u2009\u00b1\u20091.3\u00a0min, as well as the feasibility of a three-trocar technique for minimal scarring and potential for outpatient application in select cases. The mean time to discharge was 2.0\u2009\u00b1\u20090.9\u00a0days. One major Clavien\u2013Dindo IIIb complication occurred. No device-related adverse events were reported. These results confirm the safety and performance of DEXTER in robotic-assisted hysterectomy and support its role in expanding access to robotic-assisted surgery in diverse clinical settings.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>Trial registration<\/jats:italic>\n                    : ClinicalTrials.gov NCT06473675.\n                  <\/jats:p>","DOI":"10.1007\/s11701-025-02647-0","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T03:01:12Z","timestamp":1758855672000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Multicenter evaluation of the DEXTER\u00ae Robotic Surgery System for Total Hysterectomy with Adnexal Surgery"],"prefix":"10.1007","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct06473675","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Marietta","family":"Gulz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Lucile","family":"Bodet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Streich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Habegger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Heubner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaris","family":"Erhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borjana","family":"Bogdanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael David","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"2647_CR1","doi-asserted-by":"publisher","unstructured":"Committee Opinion No 701: Choosing the Route of Hysterectomy for Benign Disease. 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BB is an employee of Distalmotion. All other authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was carried out in accordance with the protocol and with principles enunciated in the current version of the Declaration of Helsinki, Good Clinical Practice (GCP), the European Regulation on medical devices 2017\/745, ISO 14155:2020, and 21 CFR 812.28, as well as any national\/local regulations and guidelines. Approval was granted by the Swiss Ethics Committee on 14 May 2024\/Swiss National Clinical Trials Portal (SNCTP) number: SNCTP000006010. In France, observational studies that do not require any additional procedures over and above standard-of-care patient management are not subject to approval.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that study participants provided informed consent for publication of the images in Fig.\u00a0\n                      \n                      .","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"634"}}