{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:07:54Z","timestamp":1782126474655,"version":"3.54.5"},"reference-count":19,"publisher":"Galenos Yayinevi","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Background: Robotic-assisted hysterectomy (RAH) is a widely accepted minimally invasive approach for uterus removal. However, as RAH is typically performed in the umbilical region, it usually results in scars in cosmetically suboptimal locations. This is the first case of RAH with cervicosacropexy performed below the bikini line, using the new Dexter robotic system\u2122.\n\nObjectives: The aim of this article is to show the surgical steps of the first RAH with cervicosacropexy performed below the bikini line with the new Dexter robotic system\u2122 (Distalmotion), and furthermore assess the feasibility of this approach using this robotic platform.\n\nMaterials and methods: A 43-year-old woman with uterine adenomyosis and recurrent uterine prolapse underwent a robotic-assisted subtotal hysterectomy with cervicosacropexy, performed below the bikini line, using the Dexter robotic system\u2122, at the Clinic of Gynecology and Obstetrics at Universit\u00e4tsklinikum Schleswig-Holstein (UKHS) in Kiel, Germany.\n\nMain outcome measures: Perioperative data, surgical approach specifics, objective, and subjective outcomes of this new approach.\n\nResults: The procedure was performed without intra-operative complications; estimated blood loss was 10 ml. Operative time was 150 minutes, console time 120 minutes, total docking time 6 minutes. Dexter performed as expected; no device-related issues or robotic arm collisions occurred. The patient did not require pain medication and was released on the second postoperative day.\n\nConclusion: RAH performed below the bikini line using the Dexter robotic system\u2122 is a feasible, safe, and adequate procedure. These initial results should be confirmed and further extensively refurbished with larger patient cohorts, and functional and psychological outcomes need further investigation.<\/jats:p>","DOI":"10.52054\/fvvo.16.1.010","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T13:32:09Z","timestamp":1712237529000},"page":"87-91","source":"Crossref","is-referenced-by-count":12,"title":["The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system\u2122"],"prefix":"10.52054","volume":"16","author":[{"given":"I","family":"Alkatout","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Nuhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pochhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.M.","family":"Donald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Mettler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Ackermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2811","published-online":{"date-parts":[[2024,3]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Alkatout I, Mettler L, Maass N et al. Robotic surgery in gynecology. J Turk Ger Gynecol Assoc. 2016;17:224-32.","DOI":"10.5152\/jtgga.2016.16187"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Alkatout I, O\u2019Sullivan O, Peters G et al. Expanding Robotic- Assisted Surgery in Gynecology Using the Potential of an Advanced Robotic System. Medicina (Kaunas). 2023;60:53.","DOI":"10.3390\/medicina60010053"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Alkatout I, Mettler L, Maass N et al. Abdominal anatomy in the context of port placement and trocars. J Turk Ger Gynecol Assoc. 2015;16:241-51.","DOI":"10.5152\/jtgga.2015.0148"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Alkatout I. An atraumatic retractor for interdisciplinary use in conventional laparoscopy and robotic surgery. Minim Invasive Ther Allied Technol. 2018;27:265-71.","DOI":"10.1080\/13645706.2018.1440244"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Blavier A, Gaudissart Q, Cadi\u00e8re GB et al. 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Arch Gynecol Obstet. 2022;305:1481-90.","DOI":"10.1007\/s00404-021-06360-9"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Goebel K, Goldberg JM. Women\u2019s preference of cosmetic results after gynecologic surgery. J Minim Invasive Gynecol. 2014;21:64-7.","DOI":"10.1016\/j.jmig.2013.05.004"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Gueli Alletti S, Chiantera V, Arcuri G et al. Introducing the New Surgical Robot HUGO\u2122 RAS: System Description and Docking Settings for Gynecological Surgery. Front Oncol. 2022;12:898060.","DOI":"10.3389\/fonc.2022.898060"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Hahnloser D, Rrupa D, Grass F. Feasibility of on-demand robotics in colorectal surgery: first cases. Surg Endosc. 2023;37:8594-600.","DOI":"10.1007\/s00464-023-10284-7"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Monterossi G, Pedone Anchora L, Gueli Alletti S et al. 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