Clinical Outcomes of Robotic-Assisted Gynecologic Surgery: A Single-Center 70-Case Series Experience

Background Robotic-assisted surgery has emerged as an advanced minimally invasive approach in gynecology, offering enhanced visualization, precision, and ergonomics. However, real-world clinical data from Indian centers, particularly using indigenously developed robotic platforms, remain limited. Objective This study aims to evaluate the spectrum of indications, perioperative outcomes, and robotic-assisted gynecologic procedures performed with the SSI Mantra 3 Surgical Robotic System (SS Innovations International Inc., Gurugram, India) at a tertiary care center in India. Methods This retrospective case series included 70 consecutive patients who underwent robotic-assisted gynecologic surgery between August and December 2025. Procedures were performed using the SSI Mantra™ robotic system and included robotic hysterectomy (RH), robotic myomectomy (RM), and robotic cystectomy (RC) for benign gynecologic indications. Demographic variables, operative parameters (operative time, docking time, console time), estimated blood loss, length of hospital stay, and perioperative complications were analyzed using descriptive statistics. Results Of the 70 procedures, RH was the most common (31 cases, 44%), followed by RC (20 cases, 29%) and RM (19 cases, 27%). Patients undergoing RH were older than those in RM and RC, while body mass index was comparable across groups. RC demonstrated the shortest operative time (60.3 ± 18.5 minutes), lowest estimated blood loss (28.3 ± 39.6 mL), and shortest hospital stay (2.3 ± 0.8 days). RH had the longest operative time (119.3 ± 44.0 minutes) but remained associated with acceptable blood loss (113.8 ± 66.9 mL) and short hospitalization (2.7 ± 0.8 days). No intraoperative or postoperative complications were observed in any group. Conclusion Robotic-assisted gynecologic surgery using the SSI Mantra™ system is safe, feasible, and effective across a broad range of benign gynecologic conditions. The favorable perioperative outcomes, minimal blood loss, short hospital stay, and absence of complications support the integration of this indigenous robotic platform into contemporary minimally invasive gynecologic practice in India.