Single-port versus multiport robotic assisted peritoneal flap vaginoplasty: perioperative, surgical and analgesic outcomes from a single-center cohort.

Authors

Ignacio Gondolesi, Isabella Mirro, Daniel M Callahan, Niki Iasinovschi, Samer Jaber Di Tommaso, Anne Yin, Miroslav L Djordjevic, Rajveer S Purohit, Michael A Palese

Published in

Journal of robotic surgery. Volume 20. Issue 1. Nov 10, 2026. Epub Nov 10, 2026.

Abstract

We compared perioperative and postoperative outcomes between single-port and multiport robotic assisted peritoneal flap vaginoplasties. Patients undergoing peritoneal flap vaginoplasty at our tertiary care institution between 2022 and 2026 were retrospectively reviewed. Cases were stratified according to the robotic platform utilized: multiport (MP) or single-port (SP). Demographic characteristics, intraoperative variables, and postoperative outcomes were collected and analyzed. Continuous variables were compared using Mann-Whitney U test. Categorical variables were compared using the chi-square test or Fisher's exact test; between-group differences are reported with 95% confidence intervals. A sensitivity analysis was restricted to the period of concurrent platform use. All statistical tests were two-sided, with p<0.05 considered statistically significant. A total of 167 patients underwent robotic assisted peritoneal flap vaginoplasty (78 SP, 89 MP). Baseline characteristics, operative time, and estimated blood loss did not differ significantly between groups. Length of stay was longer after SP (median 3 vs. 4 days; p<0.001), but not in a concurrent-period analysis (p=0.339). Overall, 90-day complications did not differ (MP 28.1% vs. SP 28.2%; difference -0.1 percentage points, 95% CI -13.7 to 13.3; p=0.987). Clavien-Dindo grade 1 complications were more frequent after MP (15.7% vs. 3.8%; p=0.011), grade 2 numerically more frequent after single-port (7.9% vs. 17.9%; p=0.050), and grade ≥3 similar (4.5% vs. 6.4%; p=0.735). Pain, opioid use, readmissions, and stenosis requiring revision did not differ significantly. Follow-up was longer after MP (p<0.001). No significant differences in complications, operative time, or postoperative pain were detected between SP and MP approaches, although the study was not powered to exclude small differences. Platform selection may therefore be guided by surgeon experience, institutional resources, and patient-specific considerations. The impact of the reduced abdominal incision burden associated with the SP platform on cosmetic outcomes warrants further study.

PMID:
43007588
Bibliographic data and abstract were imported from PubMed on 11 Nov 2026.

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