Robot-assisted gynecological surgery enhances precision, shortens recovery time, and reduces postoperative complications. However, its impact on patient-reported outcomes and their quality of life remains underexplored. This study evaluates the patient’s quality of life following robot-assisted gynecological surgeries, focusing on physical function, pain, vitality, and sexual health. A prospective non-randomized study was conducted, assessing quality of life using validated tools before and at multiple intervals post-surgery using the RAND-36 survey, the Brief Pain Index and the Female Sexual Function Index. Subgroups included patients undergoing robot-assisted hysterectomy, myomectomy, cystectomy or both myomectomy and cystectomy. Significant improvements in quality of life were observed as early as 3 weeks post-surgery, with continued gains at 12 and 24 weeks, where maximum quality of life was achieved. Pain scores decreased from baseline to week 3 and remained consistently low thereafter. Vitality scores returned to baseline within 3 weeks, indicating a faster recovery compared to laparoscopic and traditional open surgeries. Sexual health outcomes initially declined post-surgery but gradually improved over six months. These findings suggest that robot-assisted gynecological surgery enhances long-term quality of life and offers a quicker recovery compared to conventional surgical approaches. However, the non-randomized study design limits the generalizability of the results, underscoring the need for randomized controlled trials to validate these outcomes and further refine patient care strategies.

1. Johansson B, Eriksson E, Berglund N, Lindgren I (2021) Robotic surgery: review on minimally invasive techniques. Fusion of Multidisciplinary Reasearch: An International Journal 2(2):201–210. https://doi.org/10.63995/GQNC2594
2. Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN et al (2008) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol 199(4):360e361–360e369. https://doi.org/10.1016/j.ajog.2008.08.012
3. Herling SF, Moller AM, Palle C, Thomsen T (2016) Health-related quality of life after robotic-assisted laparoscopic hysterectomy for women with endometrial cancer–a prospective cohort study. Gynecol Oncol 140(1):107–113. https://doi.org/10.1016/j.ygyno.2015.10.024
4. Uccella S, Bonzini M, Palomba S, Fanfani F, Ceccaroni M, Seracchioli R et al (2016) Impact of obesity on surgical treatment for endometrial cancer: a multicenter study comparing laparoscopy vs open surgery, with propensity-matched analysis. J Minim Invasive Gynecol 23(1):53–61. https://doi.org/10.1016/j.jmig.2015.08.007
5. Angioli R, Terranova C, Plotti F, Ricciardi R, De Cicco Nardone C (2015) Reply to: is there only CO2 insufflation pressure impact on surgical field visualization during robotic surgery? Arch Gynecol Obstet 292(6):1179–1180. https://doi.org/10.1007/s00404-015-3877-9
6. Harr JN, Haskins IN, Amdur RL, Agarwal S, Obias V (2018) The effect of obesity on laparoscopic and robotic-assisted colorectal surgery outcomes: an ACS-NSQIP database analysis. J Robot Surg 12(2):317–323. https://doi.org/10.1007/s11701-017-0736-7
7. Stephan JM, Goodheart MJ, McDonald M, Hansen J, Reyes HD, Button A et al (2015) Robotic surgery in supermorbidly obese patients with endometrial cancer. Am J Obstet Gynecol, 213(1), 49 e41-49 e48. https://doi.org/10.1016/j.ajog.2015.01.052
8. Flynn KE, Lin L, Bruner DW, Cyranowski JM, Hahn EA, Jeffery DD et al (2016) Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of U.S. adults. J Sex Med 13(11):1642–1650. https://doi.org/10.1016/j.jsxm.2016.08.011
9. Lins L, Carvalho FM (2016) SF-36 total score as a single measure of health-related quality of life: scoping review. SAGE Open Med 4:2050312116671725. https://doi.org/10.1177/2050312116671725
10. RAND organization (2025) 36-Item Short Form Survey (SF-36). https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html. Accessed 1 Nov
11. Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23(2):129–138
12. Rosen C, Brown J, Heiman S, Lieiblum C, Meston R, Shabsigh D et al (2000) The female sexual function index: a multidimensional sel-report instrument for the assessment of female sexual function. J Sex Martital Therapy 26(2):191–208. https://doi.org/10.1080/009262300278597
13. Kluivers KB, Hendriks JC, Mol BW, Bongers MY, Bremer GL, de Vet HC et al (2007) Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: a randomized, controlled trial. J Minim Invasive Gynecol 14(2):145–152. https://doi.org/10.1016/j.jmig.2006.08.009
14. Kluivers KB, Cate T, Bongers FA, Brolmann MY, H. A., Hendriks JC (2011) Total laparoscopic hysterectomy versus total abdominal hysterectomy with bilateral salpingo-oophorectomy for endometrial carcinoma: a randomised controlled trial with 5-year follow-up. Gynecol Surg 8(4):427–434. https://doi.org/10.1007/s10397-011-0668-6
15. Yurtkal A, Canday M (2024) Optimizing hysterectomy: a prospective comparative analysis of surgical techniques and their impact on women’s lives. J Pers Med. https://doi.org/10.3390/jpm14030265
16. Cleeland CS (1991) The Brief Pain Inventory: User guide. https://www.mdanderson.org/documents/Departments-and-Divisions/Symptom-Research/BPI_UserGuide.pdf. Accessed 1 Nov. 2025
17. Musa AF, Yasin MSM, Smith J, Yakub MA, Nordin RB (2021) The Malay version of SF-36 health survey instrument: testing data quality, scaling assumptions, reliability and validity in post-coronary artery bypass grafting (CABG) surgery patients at the National heart Institute (Institut Jantung Negara-IJN), Kuala Lumpur. Health Qual Life Outcomes 19(1):50. https://doi.org/10.1186/s12955-020-01658-9
18. Sidi H, Puteh W, Midin SE, M., Abdullah N (2007) Female sexual dysfunction among Malaysian women in a primary care setting: does the frequency of sexual activity matter? Med Health 2(1):48–57
19. Abitbol J, Lau S, Ramanakumar AV, Press JZ, Drummond N, Rosberger Z et al (2014) Prospective quality of life outcomes following robotic surgery in gynecologic oncology. Gynecol Oncol 134(1):144–149. https://doi.org/10.1016/j.ygyno.2014.04.052
20. Lindfors A, Jarvholm S, Dahm-Kahler P (2023) Health-related quality of life after robotic surgery for endometrial cancer: a prospective longitudinal one-year follow-up study. Arch Gynecol Obstet 308(2):515–525. https://doi.org/10.1007/s00404-023-06917-w
21. Lundin ES, Wodlin NB, Nilsson L, Kjolhede P (2019) A prospective randomized assessment of quality of life between open and robotic hysterectomy in early endometrial cancer. Int J Gynecol Cancer 29(4):721–727. https://doi.org/10.1136/ijgc-2019-000285
22. Soto E, Luu TH, Liu X, Magrina JF, Wasson MN, Einarsson JI et al (2017) Laparoscopy vs. Robotic surgery for endometriosis (LAROSE): a multicenter, randomized, controlled trial. Fertil Steril 107(4):996–1002. https://doi.org/10.1016/j.fertnstert.2016.12.033
23. Potretzke AM, Kim EH, Knight BA, Anderson BG, Park AM, Sherburne Figenshau R et al (2016) Patient comorbidity predicts hospital length of stay after robot-assisted prostatectomy. J Robot Surg 10(2):151–156. https://doi.org/10.1007/s11701-016-0588-6
24. Kornblith AB, Huang HQ, Walker JL, Spirtos NM, Rotmensch J, Cella D (2009) Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a gynecologic oncology group study. J Clin Oncol 27(32):5337–5342. https://doi.org/10.1200/JCO.2009.22.3529
25. Rock JA (2001) Quality-of-life assessment in gynecologic surgery. J Reprod Med 46(5 Suppl):515–519
26. McCarthy M Jr., Jonasson O, Chang CH, Pickard AS, Giobbie-Hurder A, Gibbs J et al (2005) Assessment of patient functional status after surgery. J Am Coll Surg 201(2):171–178. https://doi.org/10.1016/j.jamcollsurg.2005.03.035
27. Nicholson A, Lowe MC, Parker J, Lewis SR, Alderson P, Smith AF (2014) Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Br J Surg 101(3):172–188. https://doi.org/10.1002/bjs.9394
28. World Health Organization (2025) Sexual health and well-bsing. https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/areas-of-work/sexual-health.Accessed 1 Nov
29. Meston CM, Freihart BK, Handy AB, Kilimnik CD, Rosen RC (2020) Scoring and interpretation of the FSFI: what can be learned from 20 years of use? J Sex Med 17(1):17–25. https://doi.org/10.1016/j.jsxm.2019.10.007
30. Manaf MR, Tahir MM, Sidi H, Midin M, Nik Jaafar NR, Das S et al (2014) Pre-marital sex and its predicting factors among Malaysian youths. Compr Psychiatry 55(Suppl 1):82–88. https://doi.org/10.1016/j.comppsych.2013.03.008
31. Althof SE, Meston CM, Perelman MA, Handy AB, Kilimnik CD, Stanton AM (2017) Opinion paper: on the diagnosis/classification of sexual arousal concerns in women. J Sex Med 14(11):1365–1371. https://doi.org/10.1016/j.jsxm.2017.08.013
32. Byers ES (2005) Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res 42(2):113–118. https://doi.org/10.1080/00224490509552264
33. Uluutku Bulutlar GB, Boz İzceyhan G, Bulutlar E, Vural F (2025) Evaluating the Anchorflow suture technique versus conventional continuous suturing in vaginal cuff closure during TLH: a multicenter retrospective analysis. Medicina Kaunas 61(5):813. https://doi.org/10.3390/medicina61050813
34. Chen S, Du W, Zhuang X, Dai Q, Zhu J, Fu H et al (2021) Description and comparison of acute pain characteristics after laparoscope-assisted vaginal hysterectomy, laparoscopic myomectomy and laparoscopic adnexectomy. J Pain Res 14:3279–3288. https://doi.org/10.2147/JPR.S335089
35. Bulutlar U, Uluutku Bulutlar GB, Cilli LA, Kılıççı Ç, Şahin S (2025) VNOTES hysterectomy versus laparoscopic hysterectomy: experiences and outcomes in a tertiary center. Minim Invasive Ther Allied Technol 34(4):297–302. https://doi.org/10.1080/13645706.2025.2500097
36. Bulutlar E, Uluutku Bulutlar GB, Şahin S (2025) Optimizing V-NOTES hysterectomy: a comparative analysis of gelpoint and glove techniques. Ginekol Pol 96(8):624–629. https://doi.org/10.5603/gpl.104335