Comparative Analysis of da Vinci® Xi and hinotori™ SRS Robot-Assisted Surgery Systems for Gynecologic Disorders: A Retrospective Study

<i>Background and Objectives</i>: This study aims to evaluate and compare the safety and efficacy of the da Vinci^® Xi and hinotori™ SRS robot-assisted surgical systems for gynecologic disorders. <i>Materials and Methods</i>: We conducted a retrospective study of 401 cases (43 benign uterine tumors; 88 pelvic organ prolapses; 270 low-risk endometrial cancers) of robot-assisted surgery performed at Kagoshima University Hospital between January 2017 and October 2024. Surgical factors such as the operative time, blood loss, and complication rates were analyzed and compared between the da Vinci^® Xi (332 cases) and hinotori™ SRS (69 cases) systems. Complications were classified according to the Clavien-Dindo classification, with Grade 2 or higher considered significant. <i>Results</i>: Significant differences were observed between the two groups in terms of age, body mass index, cockpit/console time, and median time from roll-in to cockpit/console start. The cockpit/console time was significantly longer for the hinotori™ SRS system (173 min) compared to the da Vinci^® Xi (156 min; <i>p</i> = 0.047). No significant differences were observed in the total operative time, blood loss, or length of hospital stay. Intraoperative complications were minimal, with one case of bladder injury and one case of vascular injury recorded for the da Vinci^® Xi. The overall postoperative complication rate was approximately 4%. <i>Conclusions</i>: Robot-assisted surgery using both the da Vinci^® Xi and hinotori™ SRS systems was found to be safe, with minimal blood loss and a low complication rate. The hinotori™ SRS system demonstrated operative outcomes comparable to those of the da Vinci Xi^® system, suggesting that it may serve as a viable alternative. Further prospective studies are warranted to evaluate the efficacy and safety of these systems.