{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:18:25Z","timestamp":1788351505283,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To compare perioperative outcomes and learning curves of robotic hysterectomy and transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) hysterectomy performed for benign gynecological conditions in a high-volume tertiary center. Methods: This retrospective cohort study included 100 patients who underwent either robotic hysterectomy (n = 44) or V-NOTES hysterectomy (n = 56) between January 2024 and July 2025. Demographic data, perioperative parameters, and postoperative outcomes were collected. Learning curves were analyzed using cumulative sum (CUSUM) and quadratic regression models. Results: A total of 100 patients were included (44 robotic, 56 V-NOTES). Baseline demographics were comparable between groups. The postoperative hemoglobin decrease was significantly lower in the robotic group (0.96 \u00b1 0.64 g\/dL vs. 1.33 \u00b1 0.93 g\/dL, p &lt; 0.05), whereas uterine weight was higher in the V-NOTES cohort (182.6 \u00b1 125.9 vs. 123.2 \u00b1 60.4 g, p &lt; 0.05). Complication rates, including three bladder injuries in the V-NOTES group and one in the robotic group, showed no significant difference. Hospital stay was similar across groups. Conclusions: Both techniques are safe and effective. Robotic hysterectomy offers shorter operative time and less blood loss, while V-NOTES provides cosmetic and recovery advantages. Learning curve analysis indicates a longer adaptation period for V-NOTES, with anterior colpotomy as the most critical step, whereas robotic hysterectomy demonstrates a shorter and more straightforward learning process.<\/jats:p>","DOI":"10.3390\/jcm14248743","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T16:11:18Z","timestamp":1765383078000},"page":"8743","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Minimally Invasive Hysterectomy Approaches: Comparative Learning Curves and Perioperative Outcomes of Robotic Versus V-NOTES Techniques"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5608-060X","authenticated-orcid":false,"given":"Sercan","family":"Kantarc\u0131","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-4401","authenticated-orcid":false,"given":"Alaattin","family":"Karabulut","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3015-0909","authenticated-orcid":false,"given":"U\u011furcan","family":"Da\u011fl\u0131","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4148-3210","authenticated-orcid":false,"given":"Batuhan","family":"Bayku\u015f","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3593-6628","authenticated-orcid":false,"given":"Serhat","family":"Sar\u0131kaya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0683-0710","authenticated-orcid":false,"given":"Mehmet","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Erzurum City Hospital, 25240 Erzurum, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-5805","authenticated-orcid":false,"given":"Alper","family":"\u0130leri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4782-3955","authenticated-orcid":false,"given":"Abdurrahman Hamdi","family":"\u0130nan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Tepecik Education and Research Hospital, 35020 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Whiteman, M.K., Hillis, S.D., Jamieson, D.J., Morrow, B., Podgornik, M.N., Brett, K.M., and Marchbanks, P.A. 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