On January 22, 2026, Professor Zheng Ying's team from the Department of Gynecology at West China Second University Hospital of Sichuan University successfully performed a transumbilical single-port uterine manipulator-free radical hysterectomy for cervical cancer using the Shurui® snake-arm surgical robot. Authoritative novelty search confirmed this as the world's first such procedure using a single-port robot-assisted system. The surgery proceeded smoothly and steadily throughout, and the patient recovered well postoperatively. This technique deeply integrates the Shurui® single-port robotic platform with the tumor-free concept of avoiding a uterine manipulator, offering cervical cancer patients a new treatment option that is safer, more minimally invasive, and more humane. It also marks a significant advancement in the clinical application of domestically produced single-port robots in the field of gynecologic malignancies.

Cervical cancer is a common malignancy of the reproductive system that poses a serious threat to women's health. Radical surgery is the core treatment for early-stage cervical cancer. The traditional classic approach is open surgery. With the standardized development of minimally invasive surgical techniques, how to minimize surgical trauma and accelerate postoperative recovery while strictly adhering to the tumor-free principle has become an important clinical consideration. With the evolution of minimally invasive surgical concepts and innovations in surgical robotics, gynecologic oncology surgery is rapidly advancing towards being "safer and more efficient, less traumatic, more precise, and enabling faster recovery." Robotic surgical systems, with their high-definition three-dimensional vision, tremor filtration, and flexible manipulator arms, can achieve precise anatomical dissection and radical resection even while avoiding mechanical tumor compression from a uterine manipulator, providing a new technical pathway for the minimally invasive treatment of early-stage cervical cancer.

The patient receiving this surgery was 36 years old and was preoperatively diagnosed with cervical adenocarcinoma stage IB1 (T1B1N0M0). Considering the patient's young age and high demands for quality of life and postoperative recovery, Professor Zheng Ying's team, after systematic evaluation, decided to adopt the less traumatic single-port robot-assisted uterine manipulator-free surgical approach. The core technology of this procedure lies in the unique design of the single-port robotic platform: through a single 2.5 cm umbilical incision, it integrates one 3D high-definition endoscope and three snake-arm surgical instruments. Among these, the third manipulator arm is specifically used to lift a cerclage tape, achieving active suspension and precise exposure of the uterus. This innovative design completely replaces the function of the traditional uterine manipulator, thereby avoiding compression and displacement of the tumor tissue, strictly adhering to the tumor-free principle of oncologic surgery, and significantly reducing the risk of intraoperative tumor dissemination. The deep integration of the manipulator-free technique with the single-port robotic platform places extremely high demands on equipment performance, team coordination, and the operator's experience. It is precisely based on Professor Zheng Ying's team's continuous in-depth exploration and technical breakthroughs in the field of minimally invasive surgery that this procedure was successfully implemented, demonstrating significant clinical innovation value and exemplary significance.

**Surgical Record: Standardized Process Enables Precise Operation Through a Single Small Incision**

On the day of surgery, in close collaboration with the Anesthesia and Surgical Center team, Professor Zheng Ying's team precisely executed the surgery according to the pre-established plan. The entire process was standardized and smooth:

**01 Patient Positioning and Robot Docking:** The patient was placed in the lithotomy position. A 2.5 cm longitudinal incision was made in the umbilicus. The dedicated single-port device was inserted, pneumoperitoneum was established, and the robot was docked.

**02 Adnexal Management:** Both fallopian tubes were removed, and both ovaries were preserved.

**03 Bilateral Sentinel Lymph Node Resection:** The vascular sheaths were carefully dissected, and the visualized bilateral sentinel lymph nodes were completely removed.

**04 Uterine Suspension:** The uterine body was encircled with a cerclage tape. The third manipulator arm lifted the cerclage tape, flexibly adjusting direction and tension to clearly expose the uterine ligaments and spaces.

**05 Ligament Management:** The vesicovaginal and paravesical spaces were opened, as were the rectovaginal and pararectal spaces. The bladder was adequately pushed down. The ureteral tunnel was opened, the ureters were freed, and the parametrial tissues including the uterosacral and cardinal ligaments were extensively resected.

**06 Vaginal Closure and Transection:** The vaginal wall was closed using barbed suture, and the vaginal cuff was circumferentially incised.

**07 Specimen Retrieval and Vaginal Cuff Suturing:** The specimen was completely retrieved transvaginally, and a drain was placed. The vaginal cuff was sutured with barbed suture, the ovaries were fixed, and the abdomen was closed.

Throughout the surgery, facilitated by the close collaboration of the surgeons, anesthesia team, and nursing staff at West China Second University Hospital, as well as the single-port robot's 3D high-definition vision and flexible snake-arm operation, the anatomical layers were clear, the movements were precise and stable, effectively avoiding damage to blood vessels, ureters, and surrounding tissues. Intraoperative bleeding was minimal, and trauma was controlled, perfectly achieving the dual goals of "tumor eradication + minimally invasive protection."

This world-first single-port robot-assisted uterine manipulator-free radical hysterectomy for cervical cancer breaks through traditional surgical limitations, integrating multiple cutting-edge technologies with prominent core advantages:

- **Less Trauma:** Utilizes a single 2.5 cm umbilical incision, which is concealed and aesthetically pleasing, resulting in less postoperative pain and faster recovery.

- **Safer Tumor-Free Operation:** Relies on the coordinated operation of the single-port robot's three manipulator arms, with the third arm precisely lifting the cerclage tape to achieve active uterine suspension and exposure, completely eliminating the uterine manipulator, avoiding tumor compression, and strictly adhering to the tumor-free principle.

- **Clearer Visualization:** The 3D high-definition endoscope works in concert with intelligent tremor filtration, providing a magnified, clear surgical field that allows for precise dissection and suturing within the narrow pelvic cavity.

- **More Stable Operation:** The three snake arms form a stable operating triangle, effectively reducing instrument collision, overcoming the limitations of single-port surgery, significantly lowering surgical difficulty, and enhancing overall safety and controllability.

Authoritative novelty search confirmed this as the world's first procedure to perfectly combine the advantages of a single-port robotic platform with the minimally invasive, manipulator-free concept, achieving significant improvements in trauma control, oncologic safety, cosmetic outcomes, and postoperative rehabilitation. It provides a superior treatment option for patients with early-stage cervical cancer and further expands the clinical application boundaries of domestically produced single-port robots in the field of gynecologic malignancies.

Professor Zheng Ying, Chief Physician, Doctoral Supervisor, and Director of the Gynecological Endoscopy Center at West China Second University Hospital of Sichuan University, has long been dedicated to clinical and basic research in gynecologic oncology and minimally invasive gynecologic diagnosis and treatment. She possesses profound expertise in the field of single-port laparoscopy and robotic single-port surgery for gynecologic malignancies. As a leading scholar in this field, Professor Zheng Ying has innovatively established a key technical system for gynecologic single-port minimally invasive surgery and achieved numerous breakthrough results in high-difficulty surgical operations, fully demonstrating her outstanding clinical innovation capabilities and academic influence. Her research achievements have not only promoted the standardized application of minimally invasive techniques in the treatment of gynecologic tumors but have also made significant contributions to establishing China's position at the international forefront of this field.

The Department of Gynecology at West China Second University Hospital of Sichuan University, as a National Key Clinical Specialty, has long adhered to standardized, minimally invasive, and individualized treatment for gynecologic tumors and holds a leading domestic position in single-port laparoscopy and robotic single-port surgery. The successful implementation of this world-first single-port robot-assisted manipulator-free radical hysterectomy for cervical cancer represents another successful practice of domestically produced surgical robots in the field of gynecologic malignancies. In the future, the team will continue to focus on patients, deeply cultivate innovation and translation in minimally invasive techniques, continuously improve diagnostic and treatment levels, and safeguard the health of women with more precise, less invasive, and safer medical services.