The first report of surgery for gynecological diseases using the hinotori™ surgical robot system

Objective: This study aimed to report the first surgery for gynecological diseases using a new robotic platform, the hinotori (TM), and validate its feasibility in clinical settings.Methods: The world's first robot-assisted total hysterectomy for a gynecological ailment was carried out at Kagoshima University Hospital in December 2022 utilizing the hinotori (TM) surgical robot system. Eleven other patients then underwent comparable procedures. The surgical team was certified to execute the procedure and had undergone official hinotori (TM) training.Results: Preoperative diagnoses indicated five cases of endometrial cancer, four cases of uterine myoma and one case each of atypical endometrial hyperplasia, uterine adenosarcoma and highgrade cervical intraepithelial neoplasia. Median age and body mass index were 51 (range: 38-70) years and 26.9 (range: 17.3-33.3) kg/m(2), respectively. Median roll-in, cockpit and operation times were 15 (range: 10-18), 161 (range: 110-225) and 214 (range: 154-287) min, respectively. The median blood loss was 22 (range: 7-83) mL and conversion to laparotomy was not allowed. Only one patient had postoperative pelvic region infection. The median length of hospital stay was 6 (range: 4- 10) days.Conclusion: Based on our experience with presented 12 cases, robotic surgery with the hinotori (TM) is a feasible technique of minimally invasive surgery for gynecological diseases.