Robot-assisted versus open radical hysterectomy: A multi-institutional experience for early-stage cervical cancer

Sert, Bilal; Boggess, John F.; Ahmad, Sarfraz; Jackson, Amanda; Stavitzski, Nicole M.; Dahl, Arve; Holloway, Robert W.

doi:10.1016/j.ejso.2015.12.014

Cited by 134 publications

(98 citation statements)

References 41 publications

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“…In recent years, robotic technology has further increased the spread of minimally invasive surgery, and many studies have emphasized its safety and further advantages in carrying out some of the most complex surgical procedures . The main characteristics of robotic technology that facilitate surgical performances also help to shorten the learning curve, including three‐dimensional visualization, articulated instrumentation, and stability of the camera .…”

Section: Introductionmentioning

confidence: 99%

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

Gallotta

Federico

Gaballa

et al. 2018

Journal of Surgical Oncology

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Background and Objective This study aims to investigate the surgical outcomes observed in robotic transperitoneal aortic lymphadenectomy (AL) in gynecological cancer patients. Methods Retrospective data were collected and analyzed on 71 patients undergoing robotic surgical procedures for gynecological cancers, including transperitoneal AL, between December 2014 and February 2018 at the Catholic University of the Sacred Heart, Rome, Italy. Results Median age of the sample population was 50 years (range, 26‐76 years). The median operative time was 210 minutes (range, 75‐480 minutes), the median estimated blood loss was 50 ml (range, 20‐300 ml). The number of para‐aortic nodes removed was 12 (range, 7‐43). In the whole series, 13 patients (18.3%) had at least one metastatic node. Overall, 10 patients (14.1%) experienced any grade early postoperative complications. Three patients experienced more than one complication. Three intraoperative complications occurred with two cases of vascular injury. Conversion to laparotomy was necessary for one patient (1.4%). Conclusions The present study shows the safety and adequacy of robotic transperitoneal AL as surgical staging step for gynecological cancers in terms of perioperative and postoperative outcomes.

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Section: Introductionmentioning

confidence: 99%

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

Gallotta

Federico

Gaballa

et al. 2018

Journal of Surgical Oncology

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“…Seven studies evaluated and compared operative times, length of post-surgical hospitalization, and estimated blood loss between robotic and open radical hysterectomy 52–57. All of the studies found similar results regarding significantly shorter length of post-surgical hospitalization after robotic surgery, ranging from 1 to 3.7 days for robotic-assisted procedures and 2.8 to 5 days for open surgery.…”

Section: Robotic Surgery For Malignant Indicationsmentioning

confidence: 98%

“…A total of seven studies compared robotic radical hysterectomy with either laparoscopic hysterectomy51 or open radical hysterectomy 52–57. In addition, we chose to include two more studies: one summary of 3 years of robotic radical hysterectomy experience58 and one prospective non-randomized phase II study 59…”

Section: Robotic Surgery For Malignant Indicationsmentioning

confidence: 99%

“…Two studies54,55 found no significant differences between the two surgical approaches. Three studies51,53,57 found that robotic surgery required longer operative times ( P <0.001). The two remaining studies52,58 showed the exact opposite results regarding operative times, reporting that robotic surgery had shorter operative times ( P =0.002).…”

Section: Robotic Surgery For Malignant Indicationsmentioning

confidence: 99%

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Review of Robotic Surgery in Gynecology—The Future Is Here

Lauterbach¹,

Matanes²,

Löwenstein³

2017

Rambam Maimonides Med J

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The authors present a systematic review of randomized and observational, retrospective and prospective studies to compare between robotic surgery as opposed to laparoscopic, abdominal, and vaginal surgery for the treatment of both benign and malignant gynecologic indications. The comparison focuses on operative times, surgical outcomes, and surgical complications associated with the various surgical techniques. PubMed was the main search engine utilized in search of study data. The review included studies of various designs that included at least 25 women who had undergone robotic gynecologic surgery. Fifty-five studies (42 comparative and 13 non-comparative) met eligibility criteria. After careful analysis, we found that robotic surgery was consistently connected to shorter post-surgical hospitalization when compared to open surgery, a difference less significant when compared to laparoscopic surgery. Also, it seems that robotic surgery is highly feasible in gynecology. There are quite a few inconsistencies regarding operative times and estimated blood loss between the different approaches, though in the majority of studies estimated blood loss was lower in the robotic surgery group. The high variance in operative times resulted from the difference in surgeon’s experience. The decision whether robotic surgery should become mainstream in gynecological surgery or remain another surgical technique in the gynecological surgeon’s toolbox requires quite a few more randomized controlled clinical trials. In any case, in order to bring robotic surgery down to the front row of surgery, training surgeons is by far the most important goal for the next few years.

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“…Since the Food and Drug Administration has released the Da Vinci Surgical System in gynecology, the number of experiences on the feasibility, safety, and reproducibility of most of the gynecological procedures, traditionally performed either with open and conventional laparoscopic approach, also through robotics, has rapidly and constantly increased …”

Section: Introductionmentioning

confidence: 99%

Survival outcomes of robotic radical hysterectomy for early stage cervical cancer: A 9‐year study

Siesto

Finco

Portuesi

et al. 2019

Robotics Computer Surgery

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Background Recently, the results of a RCT have raised concerns on the management of cervical cancer through a minimally invasive approach. This study reports on the outcomes of patients with early stage cervical cancer submitted to robotics. Methods Retrospective review of a consecutive series of patients with an early cervical cancer treated with robotics at a single Institution over a 9‐year period. Results A total of 91 women were managed; 39 (41.1%) had cervical adenocarcinoma. One (1.1%) conversion to laparotomy and one (1.1%) intraoperative complication occurred. Five (5.5%) patients experienced postoperative (>G2) complications; 24 (26.4%) patients required further adjuvant therapies. After a median follow‐up of 40.7 (3.8‐96.6) months, the DFS and OS were 90.4 (95%CI 85.3‐95.6)% and 94.5 (95%CI 91.8‐97.2)%, respectively. Conclusions According to the available literature, the survival outcomes of this series of RRH for ECC are not inferior to what recorded in the past by an open approach.

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Robot-assisted versus open radical hysterectomy: A multi-institutional experience for early-stage cervical cancer

Cited by 134 publications

References 41 publications

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

Review of Robotic Surgery in Gynecology—The Future Is Here

Survival outcomes of robotic radical hysterectomy for early stage cervical cancer: A 9‐year study

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