The Contribution of Robotics in Gynecological Surgery

Robot-assisted surgery is progressively establishing itself as the standard of care in gynecology, particularly for complex benign and malignant hysterectomies. In France, approximately 120 Da Vinci robots are installed, yet only 15.6% of eligible procedures are performed robotically, with significant regional disparities between well-equipped university hospitals and underserved areas where access to this technology remains almost nonexistent. In Saint-Étienne, the first Single Port (SP) robot arrived in September 2024, with over 260 SP procedures performed to date. This single-arm platform enables innovative surgical approaches (vaginal, retroperitoneal, mammary) through a single 2.5 cm incision, with a learning curve of fewer than 10 cases.
Patient benefits are now well-documented. Robotic surgery reduces hospital stay and enables same-day discharge, shortens return to normal activity from 6 weeks to just 10 days, cuts complication rates from 15% to under 3%, and replaces multiple incisions or open laparotomies with a single near-invisible scar. Postoperative pain is also significantly reduced, with markedly improved analgesic management. From a health-economic standpoint, the Robot+ERAS combination generates savings of €1,058 per patient compared to standard laparoscopy, rising to €1,685 in obese patients (BMI > 30), driven by fewer complications and shorter hospital stays.
Looking ahead, AI integration for preoperative planning, ICG fluorescence guidance, haptic feedback, and digital twin simulation will further transform the field. The surgeon of 2030 will be augmented — not replaced.