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Gynecologic Robotic Surgery: Evolution, Current Status and Future Directions
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Gynecologic Robotic Surgery: Evolution, Current Status and Future Directions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 13 September 2026 | Viewed by 1409

Editor

Dr. Youn-Jee Chung

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Interests: minimally invasive gynecological surgery; robot surgery; adenomyosis; uterine fibroids; endometriosis

Special Issue Information

Dear Colleagues,

Over the past two decades, gynecologic surgery has undergone a paradigm shift driven by the rapid adoption of minimally invasive and robotic-assisted techniques. Robotic platforms have expanded the technical feasibility of complex procedures, offering enhanced dexterity, three-dimensional visualization, and improved ergonomics, thereby challenging the traditional dominance of open surgery in benign and oncologic gynecology. In particular, robot-assisted laparoscopic surgery has gained increasing attention for technically demanding procedures such as adenomyomectomy, where meticulous dissection, multilayer uterine reconstruction, and fertility preservation are critical.

This Special Issue aims to provide a comprehensive overview of the past development, current clinical applications, and future directions of gynecologic robotic surgery. Comparative evidence—including robot-assisted laparoscopic versus open adenomyomectomy—will be highlighted to critically evaluate surgical outcomes, perioperative safety, reproductive outcomes, and long-term disease control. In addition, emerging indications, learning curves, technological innovations, and the role of robotics in precision surgery will be explored.

Original research articles, systematic reviews, and narrative reviews addressing robotic surgery across benign gynecologic diseases, fertility-sparing surgery, and complex reconstructive procedures are welcome. We look forward to contributions that advance the evidence-based integration of robotic surgery into contemporary gynecologic practice.

In this Special Issue, original articles and reviews are welcome. We look forward to receiving your contributions.

Dr. Youn-Jee Chung
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • laparoscopy
  • robot surgery
  • minimally invasive surgery
  • gynecology
  • endometriosis
  • myoma
  • adenomyosis

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Published Papers (2 papers)

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Research

15 pages, 763 KB  
Article
Impact of Body Mass Index on Perioperative Outcomes in Robotic-Assisted Total Hysterectomy: A Retrospective Cohort Study
by Zeynep Atas Elfrink, Fabinshy Thangarajah, Rainer Kimmig and Roland Csorba
J. Clin. Med. 2026, 15(13), 5067; https://doi.org/10.3390/jcm15135067 - 29 Jun 2026
Viewed by 345
Abstract
Background/Objectives: The rising global prevalence of obesity presents an increasing challenge in gynecologic surgery. Although robotic-assisted hysterectomy is widely used, comparative data on perioperative outcomes across body mass index (BMI) categories remain limited. We evaluated whether higher BMI is associated with longer [...] Read more.
Background/Objectives: The rising global prevalence of obesity presents an increasing challenge in gynecologic surgery. Although robotic-assisted hysterectomy is widely used, comparative data on perioperative outcomes across body mass index (BMI) categories remain limited. We evaluated whether higher BMI is associated with longer operative duration and increased perioperative complications in robotic-assisted total hysterectomy performed for benign indications. Methods: This retrospective cohort study analyzed 179 patients who underwent robotic-assisted hysterectomy at a German academic medical center between January 2018 and December 2024. Patients were stratified by World Health Organization criteria into normal weight (BMI < 25 kg/m2; n = 51), overweight (BMI 25.0–29.9 kg/m2; n = 59), and obese (BMI ≥ 30 kg/m2; n = 69) groups. The primary outcome was operative time; secondary outcomes included estimated blood loss (EBL), Clavien–Dindo complications, hospital stay, transfusion, and readmission within six weeks. Multivariable regression adjusted for uterine weight, surgeon volume, ASA class, year of surgery, and prior abdominal operations. Results: Operative time increased significantly with BMI (normal: 136.3 ± 68.7 vs. obese: 174.4 ± 74.3 min; p = 0.009). On multivariable analysis, BMI remained an independent predictor of operative time (β = 2.49 min per kg/m2, 95% CI 1.01–3.96, p = 0.001) and EBL (β = 15.0 mL per kg/m2, 95% CI 1.5–28.5, p = 0.029). Postoperative hemoglobin and transfusion rates did not differ between groups. No significant differences were detected in major complication rates (Clavien–Dindo ≥ III: 4/51 [7.8%], 1/59 [1.7%], 7/69 [10.1%]; p = 0.15), hospital stay, or readmission. High-volume surgeon status (≥30 cases) was independently associated with reduced major complications (OR = 0.16, 95% CI 0.03–0.75, p = 0.020). Conclusions: Robotic-assisted hysterectomy appears clinically feasible across all BMI categories without a detectable increase in major morbidity, although obesity was associated with moderately longer operative times and higher calculated EBL. The study was not powered to detect differences in rare events. Surgeon experience was independently associated with lower complication rates and may help offset the additional technical demands of obesity. Full article
(This article belongs to the Special Issue Gynecologic Robotic Surgery: Evolution, Current Status and Future Directions)
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12 pages, 443 KB  
Article
Robot-Assisted Laparoscopic Versus Open Adenomyomectomy: Comparative Surgical and Reproductive Outcomes
by Jung Hyun Park, Jae-Yen Song, Mee-Ran Kim and Youn-Jee Chung
J. Clin. Med. 2026, 15(6), 2120; https://doi.org/10.3390/jcm15062120 - 10 Mar 2026
Viewed by 686
Abstract
Background/Objectives: This study aimed to compare the surgical and reproductive outcomes between open and robot-assisted laparoscopic adenomyomectomy in women with symptomatic adenomyosis. Methods: This was a prospective cohort study conducted between 29 April 2017 and 21 December 2023 at a university-affiliated [...] Read more.
Background/Objectives: This study aimed to compare the surgical and reproductive outcomes between open and robot-assisted laparoscopic adenomyomectomy in women with symptomatic adenomyosis. Methods: This was a prospective cohort study conducted between 29 April 2017 and 21 December 2023 at a university-affiliated tertiary hospital in Seoul, Republic of Korea. The study included patients who underwent uterus-sparing adenomyomectomy for symptomatic adenomyosis. Eligible participants were premenopausal women seeking fertility preservation or symptomatic relief when medical therapy was ineffective and hysterectomy was not desired. Interventions consisted of open adenomyomectomy and robot-assisted laparoscopic adenomyomectomy. Results: A total of 76 patients were included: 21 underwent open adenomyomectomy (OA) and 55 received robot-assisted laparoscopic surgery (RLA). Patients in the OA group had larger adenomyotic lesions (7.1 ± 2.7 vs. 5.4 ± 1.7 cm, p = 0.001) and greater estimated blood loss (400 mL [200–700] vs. 300 mL [200–400], p = 0.05). Hospitalization was significantly shorter in the RLA group (β = −2.1 days, 95% CI −2.7 to −1.6, p < 0.001) after adjustment for lesion size. Overall delivery rates were comparable; however, the robotic cohort demonstrated fewer intraoperative endometrial exposures (10.0% vs. 55.6%, p = 0.033) and more favorable obstetric outcomes, with most deliveries reaching full term without postpartum complications. Conclusions: Compared with open surgery, robot-assisted laparoscopic adenomyomectomy was associated with reduced blood loss, shorter recovery, and favorable reproductive outcomes, supporting its value as a uterus-sparing treatment. Full article
(This article belongs to the Special Issue Gynecologic Robotic Surgery: Evolution, Current Status and Future Directions)
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