An International Prospective, Non-Randomized Comparative Study with Articulating Laparoscopic Instruments in Benign Adnexal Gynecologic Surgery

Articulated laparoscopic instruments such as Artisential^® offer enhanced dexterity compared with conventional tools, but evidence for their use in benign gynecologic surgery remains limited. This multicenter, prospective, non-randomized comparative study evaluated the feasibility and perioperative safety of Artisential^® instruments using contemporaneous controls. Consecutive patients undergoing laparoscopic surgery for benign adnexal disease between December 2022 and August 2024 were enrolled in Korea, Taiwan, and Japan. Patients who consented underwent surgery using Artisential^®, while those who declined were treated with conventional laparoscopic instruments and included as retrospectively collected controls. Propensity score matching was performed based on age, body mass index, history of previous abdominal surgery, and type of surgery. Outcomes included operation time, estimated blood loss, postoperative hospital stay, and Clavien-Dindo-graded complications. A total of 184 patients were analyzed, and 112 matched patients were included after matching. No significant differences were observed between groups in operative outcomes. No conversions or transfusions occurred, and postoperative complications were infrequent and limited to grade I superficial port-site issues. These findings support the feasibility and short-term safety of Artisential^® instruments in benign adnexal surgery, although randomized trials are needed to further evaluate ergonomic and economic benefits.