ORIGINAL ARTICLE The Senhance TM surgical robotic system (‘‘Senhance’’) for total hysterectomy in obese patients: a pilot study Salvatore Gueli Alletti 1 • C. Rossitto 1 • S. Cianci 1 • E. Perrone 1 • S. Pizzacalla 1 • G. Monterossi 1 • G. Vizzielli 1 • S. Gidaro 2 • G. Scambia 1 Received: 4 April 2017 / Accepted: 4 June 2017 Ó Springer-Verlag London Ltd. 2017 Abstract This pilot study was aimed to value the feasi- bility and safety of Senhance Robotic Platform for hys- terectomy in obese patients. Ten obese patients (30 \ BMI \ 40) underwent elective Senhance total extrafascial hysterectomy with bilateral salpingo- oophorectomy at the Division of Gynecologic Oncology of ‘‘Policlinico A. Gemelli’’ Foundation, Rome, Italy. Peri- operative and postoperative outcomes data were recorded. The median age was 60 years (range 51–75) and the median BMI was 33.3 kg/m 2 (range 30.4–38.3). The median uterine weight was 112.5 g (range 77–225). Indi- cation to total hysterectomy was early-stage (FIGO Stage IA) endometrial cancer in 100% of patients. The median operative time (OT) was 110 min (70–200). The median docking time was 10.5 min (5–25). The median estimated blood loss was 100 mL (50–200). No conversions to laparotomy were recorded. No intra- and 30-day postop- erative complications were registered. The median ileus was 17 h (12–36) and the median time to discharge was 2 days (1–4). The median VAS scores registered at 2, 4, 12, and 24 h were, respectively, 2 (1–3), 2 (1–3), 4 (1–8), and 3 (1–5). Our study results suggest that Senhance platform could be safe for hysterectomy even in obese patients. More clinical data are needed to determine whe- ther this approach would offer any additional benefits in a new middle line between standard laparoscopy and robotics. Keywords Laparoscopy Á Robotic Á Senhance Á Hysterectomy Á Obesity Á Telelap ALF-X Introduction In the last 10 years, surgical endoscopy has made great progress in terms of reduction of invasiveness and com- plexity in surgical procedures. One of the reasons is the advancement of dedicated technologies that allowed the surgeon to overcome the common limits linked to classical laparoscopy. In this context, introduction of robotic tech- nology has determined the possibility to extend advantages of endoscopy to obese population. The possibility to reduce the impact of surgery in this subset of patients, which represents an increasing number in worldwide statistics [1], launched a new era for both laparoscopy and robotics. It is well known that body mass index (BMI) [ 30 kg/m 2 indicates obesity and is associated with an increased risk of perioperative complications [2]. In these cases, character- ized by an increased surgical complexity compared to non- obese patients, the endoscopic approach minimizes mor- bidity associated with obesity, such as wound complica- tions and subsequent higher time of hospitalization [3, 4]. The feasibility and safety of laparoscopic and robotic procedures in obese patients were previously demonstrated [4–7]. We recently published data about surgical endo- scopic procedures performed using new robotic platform Telelap ALF-X (TRANSENTERIX Inc., USA) [8–11]. The Company has recently changed the brand that can be now referred as ‘‘Senhance’’ (TRANSENTERIX Inc., USA). & Salvatore Gueli Alletti gueliallettis@gmail.com 1 Department of Obstetrics and Gynecologic, ‘‘Policlinico Gemelli’’ Foundation, Catholic University of the Sacred Heart, L.go A. Gemelli, 1, 00168 Rome, Italy 2 Biomedical and Experimental Sciences Department, ‘‘G. D’Annunzio’’ University, Chieti, Italy 123 J Robotic Surg DOI 10.1007/s11701-017-0718-9