# The dexter robotic system in gynecological surgery: preliminary clinical data from routine use

## TL;DR

This paper presents preliminary clinical data on the Dexter robotic system used in gynecological surgery, showing it is technically feasible and safe.

## Contribution

The study provides the first consecutive case series on the Dexter robotic system's use in routine gynecological surgery.

## Key findings

- The Dexter system was used for 47 gynecological procedures with no intraoperative complications.
- Operative times varied but were longest for hysterectomy combined with cervicosacropexy.
- Blood loss was minimal (<50 ml) across all cases.

## Abstract

The Dexter robotic surgery system is a novel approach combining conventional laparoscopic and robotic surgery through an on-demand hybrid concept. Following its clinical approval in 2022, it has been used in a variety of surgical fields, but data on routine gynecological application remain limited. This study reports the first consecutive case series evaluating technical feasibility and early outcomes of the Dexter system in routine gynecological surgery. This retrospective consecutive case series included all gynecological procedures performed with the Dexter system at a single academic center between November 2022 and March 2024. Primary outcome was operative time (skin-to-skin). A total of 47 patients underwent nine different types of gynecological procedures. Benign hysterectomies were the most common (n = 28/47, 59.6%). Mean operative times varied between procedures, with the longest duration observed for hysterectomy combined with cervicosacropexy (161.0 min ± 26.0 min), followed by total hysterectomy (139.8 min ± 33.1 min) and myomectomy (131.0 ± 42.7 min). Blood loss was < 50 ml in all cases. No intraoperative complications were observed and no conversions to laparotomy or conventional laparoscopy occurred. This study demonstrates the technical feasibility of the Dexter robotic system for routine minimally invasive procedures in gynecological procedures. The on-demand hybrid concept was successfully integrated into clinical workflow. These findings provide foundational data for future comparative studies evaluating the Dexter system in gynecological surgery.