Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease. Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery. Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus ？min; ). Blood loss and length of hospital stay were significantly reduced: versus ？ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications. Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined. 1. Introduction Many techniques of hysterectomy are being used in the surgical treatment of benign gynecological disease. Laparotomy is still the commonest and the easiest one, yet it is the most invasive [1]. Abdominal laparoscopic hysterectomy and vaginal hysterectomy (VH) should be preferred because they are minimally invasive. VH does not leave scars and it can be used in obese patients. However, it may be difficult in cases of enlarged uterus, nulliparous women, and in patients with pelvic adhesions; adnexectomy may also fail in case of upper abdominal adnexal masses [2]. Total laparoscopic hysterectomy reduces blood loss and postoperative pain; it is easer to make adnexectomy and adhesiolysis and is feasible in nulliparous women [3]. Laparoscopically assisted VH allows performing adnexectomy and adhesiolysis in hysterectomic procedures ended by vaginal approach which simplifies the laparoscopic time; however, such procedure is associated with greater postoperative discomfort compared to vaginal procedure [4, 5]. Robotically assisted surgery appears “pleasant” in this indication, overcoming the laparoscopic hysterectomy limits. The rotation of the instruments, the 3D visual approach, tremor reduction, operating comfort, and the intuitive pattern of the da Vinci robot significantly simplify surgical gestures. The da Vinci robot has been authorized for hysterectomy procedures in
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