Minimally Invasive Gynecologic Surgery: Outcomes and Safety- A Multicenter Analytical Evaluation of Perioperative Performance, Oncologic Integrity, and System-Level Determinants

Dr. Anjali Gupta, Mohini Dhabhai, Dr. Nitin Kumar

Minimally Invasive Gynecologic Surgery: Laparoscopy: Robotic Surgery: Gynecologic Oncolog: Enhanced Recovery; Surgical Safety; Morcellation; Perioperative Outcomes; Subspecialty Training; Quality Metrics.

Minimally invasive gynecologic surgery (MIGS) has transformed the management of benign and malignant gynecologic conditions by reducing perioperative morbidity, shortening hospital stay, and improving recovery profiles. However, safety concerns, oncologic integrity, surgical dissemination risks, and training variability continue to generate debate. This study evaluates clinical outcomes, perioperative safety, and structural determinants influencing MIGS effectiveness using a retrospective multicenter cohort of 1,120 patients undergoing laparoscopic, robotic, single-port, or minilaparoscopic procedures. Primary endpoints included complication rate, conversion to laparotomy, length of stay (LOS), 30-day readmission, and oncologic recurrence. Logistic regression modelling identified high surgical volume (β=−0.42, p<0.001), subspecialty training (β=−0.37, p<0.001), and enhanced recovery pathway implementation (β=−0.29, p<0.01) as significant protective factors against adverse outcomes. Robotic approaches demonstrated lower conversion rates (4.8%) compared to conventional laparoscopy (7.6%, p<0.05). Morcellation-related concerns were significantly associated with unexpected malignancy dissemination risk (β=0.41, p<0.01). The final model explained 86% of variance in composite surgical outcomes (R²=0.86). Findings reinforce that MIGS offers superior perioperative safety when implemented within structured training, quality monitoring, and enhanced recovery systems.

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