Four years, single surgeon, 114 robotic gynecological surgeries:  an institutional audit from India with the Cambridge medical robotics Versius robot

Rahul Manchanda; Roshini Arunaa; Ruchika Gupta

doi:10.18203/2320-1770.ijrcog20253516

Authors

Rahul Manchanda Department of Gynaecology Endoscopy, PSRI Hospital, New Delhi, India https://orcid.org/0000-0002-6367-3005
Roshini Arunaa Department of Gynaecology Endoscopy, PSRI Hospital, New Delhi, India https://orcid.org/0009-0005-7438-6350
Ruchika Gupta Department of Gynaecology Endoscopy, PSRI Hospital, New Delhi, India https://orcid.org/0009-0003-7297-3506

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253516

Keywords:

Robotic hysterectomy, Endoscopic surgery, Versius, Endometriosis surgery, Abdominal myomectomy, Gynecological, Laparoscopy

Abstract

Background: Robotic-assisted surgery is transforming minimally invasive gynecology by offering enhanced precision, superior visualization, and ergonomic advantages over conventional laparoscopy. The Versius surgical system is a newer, modular alternative with lower infrastructure needs. However, published evidence on Versius use in gynecological surgery, particularly from India, is limited. This study evaluates a single-centre, single-surgeon experience with the Versius system over four years. Objectives were to assess the safety, feasibility, and effectiveness of robotic gynecological surgeries performed using the Versius system at a tertiary hospital in Delhi, India, over a 4-year period.

Methods: A retrospective review covered 114 consecutive benign gynecological procedures performed using Versius between July 2021 and July 2025 at PSRI hospital, Delhi. Data on patient demographics, surgical types, operative times, blood loss, complications, and hospital stay were analyzed.

Results: Robotic hysterectomy was the most common procedure (61.4%), followed by myomectomy (15%) and endometriosis surgery (12%). The mean operative time for hysterectomy was 174 minutes. Blood loss was ≤100 mL in 78% of cases. Intraoperative complications occurred in 7.9%, primarily hemorrhage, with two conversions to open or laparoscopic surgery. Postoperative recovery was uneventful in 97.5%, with a mean hospital stay of 1.08 days; most (91%) were discharged within 24 hours.

Conclusions: Versius robotic gynecological surgery is safe, feasible, and effective in an Indian tertiary setting, highlighting its promise as a cost-effective platform with low complications, minimal blood loss, and short hospital stays.

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References

Alkatout I, Salehiniya H, Allahqoli L. Assessment of the Versius robotic surgical system in minimal access surgery: a systematic review. J Clin Med. 2022;11(13):3754. DOI: https://doi.org/10.3390/jcm11133754

Advincula AP, Wang K. Evolving role and current state of robotics in minimally invasive gynecologic surgery. J Minim Invasive Gynecol. 2009;16(3):291-301. DOI: https://doi.org/10.1016/j.jmig.2009.03.003

Satava RM. Surgical robotics: the early chronicles: a personal historical perspective. Surg Laparosc Endosc Percutan Tech. 2002;12(1):6-16. DOI: https://doi.org/10.1097/00129689-200202000-00002

Maged MN, Mohamed MN, Lamia H: Robotic Surgery in Gynecology Critical Review. Int J Progress Sci Technol. 2021;28(1):NA.

Wright JD, Ananth CV, Lewin SN, William MB, Yu-Shiang L, Alfred IN, et al. Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease. JAMA. 2013;309(7):689-98. DOI: https://doi.org/10.1001/jama.2013.186

Seamon LG, Cohn DE, Richardson DL, Sue V, Matthew JC, Gary SP, et al. Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. Obstet Gynecol. 2008;112(6):1207-13. DOI: https://doi.org/10.1097/AOG.0b013e31818e4416

Barbash GI, Glied SA. New Technology and Health Care Costs-The Case of Robot-Assisted Surgery. N Engl J Med. 2010;363(8):701-4. DOI: https://doi.org/10.1056/NEJMp1006602

Lenihan Jr JP, Kovanda C, Seshadri-Kreaden U. What is the learning curve for robotic assisted gynecologic surgery? J Minim Invasive Gynecol. 2008;15(5):589-94. DOI: https://doi.org/10.1016/j.jmig.2008.06.015

NA. Committee Opinion no. 628: robotic surgery in gynecology. Obstet Gynecol. 2015;125(3):760-7. DOI: https://doi.org/10.1097/01.AOG.0000461761.47981.07

Caccomo S. FDA in brief: FDA cautions patients, providers about using robotically-assisted surgical devices for mastectomy and other cancer-related surgeries. US Food Drug Adm. 2019.

Faust RA. Robotics in surgery: history, current and future applications. Nova Publishers. 2007.

Picozzi P, Nocco U, Labate C, Isabella G, Greta P, Federica S, et al. Advances in robotic surgery: a review of new surgical platforms. Electronics. 2024;13(23):4675. DOI: https://doi.org/10.3390/electronics13234675

Rooma S, Rupa B, Reddy N. Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade. Gynecol Robot Surg. 2023;4(1):14-21. DOI: https://doi.org/10.36637/grs.2023.00164

Rajanbabu A, Patel V, Anandita A, Burde K, Appukuttan A. An analysis of operating time over the years for robotic-assisted surgery in gynecology and gynecologic oncology. J Robot Surg. 2021;15:215-9. DOI: https://doi.org/10.1007/s11701-020-01094-3

Kadioglu BG, Kumtepe Y, Baran FS. Gynecological robotic surgery at a state hospital-our own experience. Ginekol Pol. 2018;89:495-9. DOI: https://doi.org/10.5603/GP.a2018.0084

Goetgheluck J, Carbonnel M, Ayoubi JM. Robotically assisted gynecologic surgery: 2-year experience in the French foch hospital. Front Surg. 2014;1:8. DOI: https://doi.org/10.3389/fsurg.2014.00008

Patel R, Patel R. Robotic Surgery for Benign Hysterectomy: A Real-World Study From India. Cureus. 2024;22:16(12):e74932. DOI: https://doi.org/10.7759/cureus.74932

Puntambekar SP, Goel A, Chandak S, Mihir C, Mangesh H, Honey C, et al. Feasibility of robotic radical hysterectomy (RRH) with a new robotic system. Experience at Galaxy Care Laparoscopy Institute. J Robot Surg. 2021;15(3):451-6. DOI: https://doi.org/10.1007/s11701-020-01127-x

Haveman I, van Weelden WJ, Roovers EA, Kraayenbrink AA, Dijkhuizen FPH. Robot-assisted total laparoscopic hysterectomy in different classes of obesity: a cohort study. JSLS J Soc Laparosc Robot Surg. 2022;26(1):e2021.00077. DOI: https://doi.org/10.4293/JSLS.2021.00077

Martínez-Maestre MA, Gambadauro P, González-Cejudo C, Torrejón R. Total Laparoscopic Hysterectomy with and Without Robotic Assistance: A Prospective Controlled Study. Surg Innov. 2014;21(3):250-5. DOI: https://doi.org/10.1177/1553350613492023

Payne TN, Dauterive FR. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol. 2008;15(3):286-91. DOI: https://doi.org/10.1016/j.jmig.2008.01.008

Manchanda R, Mirza H, Iqbal M, Bhardwaj V. A comprehensive review of 53 gynae surgeries on the versius robotic system in a tertiary care hospital. Int J Reproduct Contracept Obstet Gynecol. 2024;13(1):134-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20234092