A Comparative Analysis of Robotic Single-Site Surgery and Laparoendoscopic Single-Site Surgery as Therapeutic Options for Stage IB1 Cervical Squamous Carcinoma

Figures & data

Figure 1 Surgical techniques in both groups utilized the same single-site port (LAGIS single-site port) manufactured in Taiwan.

Figure 2 A trans-umbilical skin incision of a transversal length of 3 cm was made.

Figure 3 Robotic monopolar scissors and fenestrated bipolar forceps were mounted through the cannulas.

Figure 4 Absorbable continuous locking sutures were used to close the umbilicus fascia and subcutaneous layer with 2-0 and 4-0 Vicryl sutures.

Table 1 The Clinical Characteristics of Cases in Both Groups

Clinical Characteristics	RSS Group (n = 32)	LESS Group (n = 35)	P-value
Age (years)	51.63±8.32	53.14±8.14	0.453 (NS)
BMI (body mass index) (kg/m^2)	23.76±2.72	23.46±2.28	0.629 (NS)
Average diameter of the tumor (cm)	2.21±0.89	2.47±0.87	0.224 (NS)
SCCA (squamous cell carcinoma antigen) (ng/mL)	3.87±2.05	4.39±1.93	0.288 (NS)
Conversion to other multi-site surgeries	0	0	NS

Abbreviations: RSS, robotic single-site surgery; LESS, laparoendoscopic single-site surgery; NS, not specific.

Table 2 Intraoperative, Perioperative and Postoperative Data

Variable	RSS Group (n = 32)	LESS Group (n = 35)	P-value
Mean total operating time (minutes)	223.56±15.43	248.61±20.89	0.000
Mean estimated blood loss (mL)	217.25±16.77	294.74±24.00	0.000
Number of lymph nodes retrieved	21.37±4.11	20.71±3.47	0.478 (NS)
Length of resected cardinal ligament tissue
Left (cm)	2.96±0.26	2.89±0.26	0.251 (NS)
Right (cm)	2.98±0.23	2.97±0.22	0.986 (NS)
Length of resected vaginal wall (cm)
Anterior wall of vagina	2.90±0.27	2.90±0.24	0.967 (NS)
Posterior wall of vagina	2.92±0.23	2.93±0.23	0.865 (NS)
Mean length of hospital stay after operation (days)	7.50±1.55	7.17±1.64	0.865 (NS)
Duration of closure and removal of catheter (days)	16.97±4.80	17.74±4.94	0.518 (NS)
Ovarian preservation	15	20	0.218 (NS)
Blood transfusion	2	3	0.498 (NS)
Urinary retention 2 weeks after operation	7	6	0.397 (NS)
Complication	2	2	0.602 (NS)

Abbreviations: RSS, robotic single-site surgery; LESS, laparoendoscopic single-site surgery; NS, not specific.

Table 3 Postoperative Pain Evaluation

Variable	RSS Group (n = 32)	LESS Group (n = 35)	P-value
6 hours after operation (score)	5.84±1.42	5.49±1.01	0.235 (NS)
12 hours after operation (score)	4.63±1.21	4.49±1.22	0.641 (NS)
24 hours after operation (score)	4.06±1.11	3.91±1.25	0.610 (NS)
48 hours after operation (score)	3.16±1.19	3.06±1.03	0.716 (NS)

Abbreviations: RSS, robotic single-site surgery; LESS, laparoendoscopic single-site surgery; NS, not specific; VAS, visual analogue scale system.

Table 4 Pathological Diagnosis After Operation

Variable	RSS Group (n = 32)	LESS Group (n = 35)	P-value
Lymphovascular space involvement	10	14	0.275 (NS)
Bilaterial parametrial involvement	2	1	0.225 (NS)
Deep stromal infiltration	12	16	0.305 (NS)
Vaginal involvement	4	3	0.361 (NS)
Metastasis in pelvic lymph node	5	8	0.289 (NS)

Abbreviations: RSS, robotic single-site surgery; LESS, laparoendoscopic single-site surgery; NS, not specific.