Language
English
Publication Date
1-1-2026
Journal
Cureus
DOI
10.7759/cureus.102729
PMID
41777973
PMCID
PMC12952751
PubMedCentral® Posted Date
1-31-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Objective: This study aims to assess the surgical outcomes and learning curve of robotic single-port vaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) for hysterectomy in benign gynecologic conditions.
Materials and methods: A retrospective observational analysis was conducted of 97 consecutively enrolled patients who underwent RSP-vNOTES hysterectomy using the da Vinci (single-port) SP system between December 2023 and July 2025 at a single tertiary care center.
Results: Median procedural durations included a total operative time of 151 minutes, a port placement time of five minutes, a docking time of two minutes, a robotic console time of 78 minutes, and a hysterectomy time of 35 minutes. One case (1.0%) required conversion to a transumbilical single-incision robotic approach for management of diaphragmatic endometriosis after completion of the vaginal hysterectomy, rather than due to failure of the hysterectomy itself. Fourteen patients (14.4%) experienced perioperative complications. Cumulative sum analysis revealed that hysterectomy time stabilized after approximately 30 cases, while port placement and docking times plateaued after 43 and 37 cases, respectively.
Conclusions: These findings suggest that proficiency in RSP-vNOTES can be achieved with sequential case experience. RSP-vNOTES appears to be a safe and effective surgical approach for hysterectomy, including complex scenarios such as endometriosis. Proficiency is typically achieved after 30 cases, particularly among surgeons with prior experience in robotic-assisted single-site and vNOTES techniques.
Keywords
da vinci sp platform, hysterectomy, learning curve, robot-assisted, vnotes
Published Open-Access
yes
Recommended Citation
Qiannan Yang, Daniel Y Lovell, and Xiaoming Guan, "Surgical Outcomes and Learning Curve of Robotic Single-Port Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Hysterectomy Using the Da Vinci Single-Port System" (2026). Faculty, Staff and Students Publications. 7360.
https://digitalcommons.library.tmc.edu/baylor_docs/7360