Pioneering robotic surgery for complex gynecologic conditions: implementation beyond cancer care

Abstract

Minimally invasive surgery was introduced to minimize some of the issues associated with open surgery. Its benefits include fewer complications, less pain and blood loss, shorter hospital stays, quicker recovery, and less noticeable scars. While laparoscopy has been the gold standard for minimally invasive surgery, robot-assisted surgery has emerged as the latest major breakthrough for minimally invasive procedures, allowing surgeons to expand its use to more complex surgical procedures and operating with more precision, flexibility, control, and comfort than is possible with traditional procedures. Here we present the successful implementation of a robotic-assisted surgery program in the gynecology department of the Spanish tertiary hospital La Paz. This included the complete training of six surgeons from the three units in the department: oncology, pelvic floor, and benign organic pathology. By the end of 2024, 184 procedures had been conducted in the first year, including interventions for both cancer (N = 46) and benign pathologies (N = 138). In these, 2.2% of patients developed Clavien–Dindo grade 2 complications. The complexity of the procedures increased during implementation of the program, whereas hospitalization times and associated costs remained low.