Initial Experience with the Saroa Surgical System in Robot-Assisted Hysterectomy: First Clinical Case Series and Haptic Feedback Assessment

<i>Background and Objectives</i>: Laparoscopic surgery has evolved with the integration of robotic systems, offering enhanced precision and ergonomic benefits. However, conventional robotic systems often lack haptic feedback and are associated with high cost. The Saroa surgical system is a compact, pneumatically driven robot that integrates real-time haptic feedback, potentially addressing the limitations associated with conventional robotic systems. This preliminary study reports the first clinical use of the Saroa system in gynecologic surgery, aiming to assess its feasibility, safety, and usability in robot-assisted hysterectomy. <i>Materials and Methods</i>: Five patients underwent robot-assisted total laparoscopic hysterectomy using the Saroa surgical system. The clinical outcomes, setup and console times, estimated blood loss, and subjective surgeon evaluation were recorded. <i>Results</i>: All surgeries were successfully completed without any intraoperative complications or the need for conversion to conventional surgery. The median setup time was 12 min, the console time was 211 min, and the median blood loss was 80 mL. Surgeons subjectively noted that the system's real-time haptic feedback substantially improved precision during vaginal cuff tissue manipulation, based on their tactile sensation and real-time force display, thereby reducing the perceived risk of traction-related tissue injuries. <i>Conclusions</i>: This study represents the first clinical application of the Saroa surgical system in gynecologic surgery. The findings suggest that the system is feasible and safe for robot-assisted hysterectomy. Despite limitations such as small sample size and the absence of objective force data, the favorable surgeon-reported experience highlights the potential value of haptic feedback in improving surgical performance. These results support further investigation through larger, controlled studies and quantitative performance evaluation.