On December 2, 2023, Professor Li Qiling’s team from Department of Obstetrics and Gynecology successfully completed the first case of robot-assisted single-port laparoscopic total hysterectomy combined with removal of the right ovarian cyst in the East District of the First Affiliated Hospital (FAH) of Xi’an Jiaotong University (XJTU).
A 47-year-old female patient, surnamed Zhang, was admitted to Department of Obstetrics and Gynecology in the East District of the FAH due to submucous myoma and anemia. After comprehensive evaluation of the patient's condition by surgical team, considering her heavy weight and the history of delayed wound healing after previous two open surgeries, the patient had a strong desire for minimally invasive surgery. After informed consents were obtained from the patient and her family, snake-arm robot-assisted single-port total hysterectomy was chosen. The procedure was performed through single-port umbilical approach. Intraoperative exploration found that the patient was complicated with the right ovarian cyst, and serious pelvic adhesion caused by previous two surgeries, which increased the difficulty of surgery. Professor Li Qiling quickly adjusted surgical plan during the operation. With excellent surgical expertise, the adhesions were carefully dissected. With intimate cooperation with Director Xue Yan’s team from Department of Obstetrics and Gynecology of East District, and surgical anesthesia team, Professor Li Qiling calmly and accurately cooperated with the single-port snake-arm robot to successfully perform total hysterectomy + removal of the right ovarian cyst. The surgery lasted for 1 h, and intraoperative bleeding was less than 10 ml. The patient was rapidly recovered after operation, and the abdominal wall scar was almost invisible after umbilical incision suture, which successfully met the minimally invasive requirement of the patient.
After the operation, Professor Li Qiling highlighted that the snake-arm single-hole robot has resolved the technical difficulty of 'chopsticks effect' of conventional single-port endoscopic surgery, and its operation is more precise and flexible. Meantime, robot-assisted single-port surgery can be completed via an incision of <3 m on the abdominal wall. Compared with traditional multi-port endoscopic surgery, there is almost no scar after umbilical incision, which meets the pursuit of beauty of female patients. Moreover, the recovery time is shortened after small incision, which can enable patients to more quickly return to normal life.
Zou Yuliang, Executive President of East District, watched and provided guidance during the whole surgical process. Postoperatively, he stressed that the FAH of XJTU was one of the earliest hospitals in China to perform robot-assisted surgery, and our hospital has been dedicated to medical engineering research and achieved fruitful results. Successful implementation of the first case of robot-assisted single-port gynecological surgery in northwest China injects new energy into the intelligent, precise and minimally invasive development of medical technology in East District, and adds new impetus to discipline construction and high-quality development of our hospital.
