Comparison between single-site and multiport robot-assisted hysterectomy in obese patients with endometrial cancer: An Italian multi-institutional study

Background: The aim of this study is to compare robotic single-site hysterectomy (RSSH) and robotic multiport hysterectomy (RMPH) for endometrial cancer (EC) in obese patients in terms of surgical outcomes. Methods: This retrospective study compares RSSH with RMPH in obese patients with EC and FIGO stages I to II divided in three classes according to their body mass index (BMI): class A (30-34.9 kg/m2), class B (35-39.9 kg/m2), and class C (>40 kg/m2). Results: We included 225 patients (RSSH: 76; RMPH: 149). The operative time and estimated blood loss (EBL) were lower in the A class of the RSSH group. The EBL and the conversion rate increased when the BMI increased in the RSSH group. The hospital stay was higher in the A class of the RMPH group. Conclusions: The advantages of RSSH in terms of reduced invasiveness remain true only in the first BMI class, whereas they are lost when the BMI increased.