{
  "abstract": "Purpose To evaluate a novel manipulator-free technique for single-port laparoscopic hysterectomy. Methods A retrospective cohort study was conducted including patients who underwent single-port laparoscopic hysterectomy between January 2022 and July 2025. Surgical outcomes were compared between the manipulator-free and manipulator-assisted groups. Propensity score matching was performed based on surgical complexity, disease status, body mass index, and uterine size. Results Among 190 patients, 88 underwent manipulator-free and 102 manipulator-assisted surgery. No conversions occurred in the manipulator-free group. Proficiency in the manipulator-free procedure was achieved after 15 cases, with a mean operative time of 35.4 ± 13.7 min (range: 19 to 89). The manipulator-free group demonstrated significantly reduced blood loss (70.6 mL vs. 103.6 mL, P = 0.003) and hemoglobin decline (9.6 g/L vs. 14.5 g/L, P < 0.001) compared to the manipulator-assisted group. These differences remained consistent after propensity score matching (56.4 mL vs. 98.6 mL, P < 0.001) and multivariable adjustment (–39.1 mL, 95% CI: − 64.6 to − 13.6; P = 0.003). Uterine perforations occurred only in the manipulator-assisted group (9.8% vs. 0%, P = 0.002). There were no significant differences between groups in rates of peritoneal cytology positivity (16.4% vs. 9.7%, P = 0.24), lymphovascular space invasion (14.9% vs. 11.1%, P = 0.50). Conclusions Manipulator-free single-port laparoscopic hysterectomy is technically feasible with a short learning curve and was associated with reduced blood loss in this cohort. In short-term follow-up, the manipulator-free technique was not associated with increased rates of positive peritoneal cytology or lymphovascular space invasion; however, its impact on long-term oncologic outcomes remains to be validated.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zejian Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Haifeng Gu"
    },
    {
      "affs": [
        0
      ],
      "name": "Guochen Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhimin Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jieping Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Hua Tu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2t0dj72p78tp8.bib",
  "cited_by": 0,
  "doi": "10.1007/s44178-026-00308-2",
  "fulltext_url": "https://doi.org/10.1007/s44178-026-00308-2",
  "id": "2t0dj72p78tp8",
  "issns": [
    "2731-4529"
  ],
  "landing_url": "https://doi.org/10.1007/s44178-026-00308-2",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "2746|Minimally Invasive Surgical Techniques"
    ]
  ],
  "openalex": "W7224286890",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s44178-026-00308-2.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/2t0dj72p78tp8.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T14:21:25Z",
      "native_id": "0c11efd1bbb6404d8553f55ecf571130",
      "source": "doaj",
      "url": "https://doi.org/10.1007/s44178-026-00308-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Minimally Invasive Surgical Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Manipulator-free technique for single-port laparoscopic hysterectomy avoids uterine perforation and reduces blood loss: a propensity score-matched study",
  "title_text": "Manipulator-free technique for single-port laparoscopic hysterectomy avoids uterine perforation and reduces blood loss: a propensity score-matched study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T14:20:52Z",
  "url": "https://research.draconitic.com/paper/2t0dj72p78tp8",
  "venue": "Holistic Integrative Oncology",
  "versions": []
}