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. 2014 Sep;5(3):217-23.
doi: 10.1007/s13193-014-0321-8. Epub 2014 Jun 21.

Prospective randomized study comparing robotic-assisted hysterectomy and regional lymphadenectomy with traditional laparotomy for staging of endometrial carcinoma -initial Indian experience

S P Somashekhar  1 , Rajshekhar C Jaka  1 , Shabber S Zaveri  1
Affiliations

Prospective randomized study comparing robotic-assisted hysterectomy and regional lymphadenectomy with traditional laparotomy for staging of endometrial carcinoma -initial Indian experience

S P Somashekhar et al. Indian J Surg Oncol. 2014 Sep.

Abstract

Robotic assisted hysterectomy with regional lymphadenectomy is increasingly used for the treatment of endometrial carcinoma. In the present study we evaluated the feasibility and technique of robotic assisted hysterectomy and lymphadenectomy in patients with endometrial carcinoma. A prospective randomized study was undertaken from July 2011 to June 2012, in 50 consecutive patients with carcinoma endometrium. Demographic (age, BMI) and perioperative data (operating time, estimated blood loss, total number of lymph nodes retrieved, hospital stay, conversion to open procedure, intraoperative and postoperative complications) of robotic assisted surgery were compared with open staging procedure. Mean age of the patient and BMI in both groups were comparable with no significant difference. Estimated blood loss (81.28 ml), hospital stay (1.94 days) and perioperative complications were significantly less in robotic assisted group in comparison to open method. Mean number of lymph nodes removed were 30.56 versus 27.6 which is suggestive of significant difference statistically. Operative time decreased as the experience of the surgeon increased but still significantly remained higher than the open procedure after 25 robotic assisted surgeries. All robotic surgeries were completed successfully without converting to open method. Robotic assisted staging procedure for endometrial carcinoma is feasible without converting to open method, with the advantages of decreased blood loss, short duration of hospital stay and less postoperative minor complications. Operative time will decrease further as the experience of surgeon increases. Para-aortic lymph node dissection is easily done and with a better ergonomics for surgeon.

Keywords: Endometrial cancer; Hysterectomy; Robotic assisted surgery; Staging laparotomy.

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Figures

Fig. 1
Fig. 1
Port placement (1- Arm one, 2- Arm two, 3- Arm three, C- Camera, A- Assistant)
Fig. 2
Fig. 2
Instruments used (Arm 1- Hot shear (scissors), Arm 2 - Bipolar, Arm 3 - Prograsper)
Fig. 3
Fig. 3
Distal limit of pelvic dissection
Fig. 4
Fig. 4
Proximal limit of pelvic dissection
Fig. 5
Fig. 5
Obturator triangle clearance in pelvic dissection
See this image and copyright information in PMC

References

    1. Magrina JP, Mutone NF, Weaver AL, et al. Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingooophorectomy for endometrial cancer: morbidity and survival. Am J Obstet Gynecol. 1999;181:376–381. doi: 10.1016/S0002-9378(99)70565-X. - DOI - PubMed
    1. Malur S, Possover M, Michels W, et al. Laparoscopic-assisted vaginal versus abdominal surgery in patients with endometrial cancer: a prospective randomized trial. Gynecol Oncol. 2001;80:239–244. doi: 10.1006/gyno.2000.6069. - DOI - PubMed
    1. Eltabbakh GH, Shamonki MI, Moody JM, et al. Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma. Cancer. 2001;91:378–387. doi: 10.1002/1097-0142(20010115)91:2<378::AID-CNCR1012>3.0.CO;2-F. - DOI - PubMed
    1. Zullo F, Palomba S, Falbo A, et al. Laparoscopic surgery vs. laparotomy for early stage endometrial cancer: long-term data of a randomized controlled trial. Am J Obstet Gynecol. 2009;200:296–305. doi: 10.1016/j.ajog.2008.10.056. - DOI - PubMed
    1. Fowler JM. The role of laparoscopic staging in the management of patients with early endometrial cancer. Gynecol Oncol. 1999;73:1–3. doi: 10.1006/gyno.1999.5385. - DOI - PubMed

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