Robot-assisted natural orifice transluminal endoscopic surgery for hysterectomy

Chyi Long Lee*, Kai Yun Wu, Hsuan Su, Chien Min Han, Chen Ying Huang, Chih Feng Yen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

25 Scopus citations


Objective To describe the surgical procedures of robot-assisted natural orifice transluminal endoscopic surgery (NOTES) for hysterectomy and to evaluate its feasibility. Materials and methods From December 2014 to February 2015, four patients with benign diseases who were eligible for robot-assisted NOTES at Chang Gung Memorial Hospital were recruited to this study. Intraoperative and postoperative surgical outcomes were evaluated. Results Robot-assisted NOTES hysterectomy was successfully performed in all these patients. None of the patients had vaginal delivery, with two being nulliparous. The mean ± standard error of the mean uterine weight was 365.5 ± 69.2 g, the mean operative time was 198.8 ± 39.0 minutes, the mean docking time was 38.3 ± 2.4 minutes, the mean blood loss was 180.0 ± 56.1 mL, and the mean postoperative hospital stay was 2.5 ± 0.3 days. The final pathologic diagnoses were adenomyosis and/or leiomyomas. Conclusion The novel robot-assisted NOTES technology created scarless skin wounds. More importantly, the device allows the surgeon to reach deeper places to achieve hemostasis, and perform surgery on larger tumors using the curved cannulae-wristed instrument. However, its implementation is limited by the lack of appropriate instrumentation, which requires further development and break through. At this stage, robot-assisted NOTES is only useful for limited applications in highly selected patients.

Original languageEnglish
Pages (from-to)761-765
Number of pages5
JournalTaiwanese Journal of Obstetrics and Gynecology
Issue number6
StatePublished - 01 12 2015

Bibliographical note

Publisher Copyright:
© 2015


  • hysterectomy
  • robot


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