TY - JOUR
T1 - Surgical outcome for robotic-assisted single-site hysterectomy (RSSH) in female-to male reassignment compared to its use in benign gynecological disease
T2 - a single center experience
AU - Gardella, Barbara
AU - Dominoni, Mattia
AU - Bogliolo, Stefano
AU - Spinillo, Arsenio
PY - 2020
Y1 - 2020
N2 - This study was oriented to assess surgical outcomes, feasibility, and safety of Robotic-assisted Single-Site Hysterectomy and bilateral salpingo-oophorectomy (RSSH/BSO) performed for sexual reassignment compared to indications for the benign gynecologic disease. The present trial is a retrospective analysis of a prospectively collected database. After the exclusion of 3 patients with endometrial cancer on histological specimens, 112 subjects were considered for final analysis: 60 transgender men (TM) and 52 cisgender women (CW). There is a statistical difference in surgical time (total operative time p = 0.0152, docking p = 0.0011, console time p = 0.0001, and anesthesia time p = 0.0061) between TM and CW. Other than in TM, a significant difference in uterine volume (p = 0.0001), Body Mass Index (p = 0.0169), and previous comorbidity (p = 0.0001) was reported. There are no differences in conversion rate, the decrease in hemoglobin and blood loss, hospital stay, intra- and postoperative complications between the two groups. RSSH for sex reassignment appears to be a safe, viable, and cost-effective option with a significant decrease in surgical time compared to other indications for benign disease. In addition, the benefit of this scar-less surgical procedure appears to be more evident in TM’s due to the absence of traditional surgical stigmata.
AB - This study was oriented to assess surgical outcomes, feasibility, and safety of Robotic-assisted Single-Site Hysterectomy and bilateral salpingo-oophorectomy (RSSH/BSO) performed for sexual reassignment compared to indications for the benign gynecologic disease. The present trial is a retrospective analysis of a prospectively collected database. After the exclusion of 3 patients with endometrial cancer on histological specimens, 112 subjects were considered for final analysis: 60 transgender men (TM) and 52 cisgender women (CW). There is a statistical difference in surgical time (total operative time p = 0.0152, docking p = 0.0011, console time p = 0.0001, and anesthesia time p = 0.0061) between TM and CW. Other than in TM, a significant difference in uterine volume (p = 0.0001), Body Mass Index (p = 0.0169), and previous comorbidity (p = 0.0001) was reported. There are no differences in conversion rate, the decrease in hemoglobin and blood loss, hospital stay, intra- and postoperative complications between the two groups. RSSH for sex reassignment appears to be a safe, viable, and cost-effective option with a significant decrease in surgical time compared to other indications for benign disease. In addition, the benefit of this scar-less surgical procedure appears to be more evident in TM’s due to the absence of traditional surgical stigmata.
KW - Female-to-male reassignment
KW - Robotic surgery
KW - Single site
KW - Transsexuals
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U2 - 10.1007/s11701-020-01143-x
DO - 10.1007/s11701-020-01143-x
M3 - Article
AN - SCOPUS:85090158984
JO - Journal of Robotic Surgery
JF - Journal of Robotic Surgery
SN - 1863-2483
ER -