Introduction The aim of this study was to evaluate the operative outcomes of robotic-assisted laparoscopic vaginectomy (RALV) and conventional laparoscopic vaginectomy (CLV) for patients with complicated vaginal high-grade squamous intraepithelial lesions (HSIL).

Methods an analysis of one hundred and nine patients with complicated vaginal HSIL (32 patients in the RALV group and 77 patients in the CLV group) who underwent minimally invasive vaginectomy was conducted retrospectively.

Results Compared with the CLV group, patients in the RALV group demonstrated less estimated blood loss, a lower rate of intraoperative complications and shorter durations of paralytic ileus time, urinary catheter indwelling time and postoperative hospitalization time (all P<0.05). However, the RALV group had significantly higher hospital costs than the CLV group (P<0.05). The total operative time, postoperative complications, positive surgical margins, pathology upgrading or treatment outcomes did not significantly differ between the two groups (all P>0.05).

Conclusion/Implications Our results demonstrated that both RALV and CLV can achieve satisfactory treatment outcomes, while RALV has the advantages of less intraoperative blood loss, fewer intraoperative complications and faster postoperative recovery. RALV has the potential to become a better choice for vaginectomy without regard to the burden of hospital costs.