Single-site robotic surgery in gynecologic cancer: a pilot study

Abstract

ObjectiveTo discuss the feasibility of single-site robotic surgery for benign gynecologic tumors and early stage gynecologic cancers.MethodsIn this single institution, prospective analysis, we analyzed six patients who had undergone single-site robotic surgery between December 2013 and August 2014. Surgery was performed using the da Vinci Si Surgical System. Patient characteristics and surgical outcomes were analyzed.ResultsSingle-site robotic surgery was performed successfully in all six cases. The median patient age was 48 years, and the median body mass index was 25.5 kg/m2 (range, 22 to 33 kg/m2). The median total operative time was 211 minutes, and the median duration of intracorporeal vaginal cuff suturing was 32 minutes (range, 22 to 47 minutes). The median duration of pelvic lymph node dissection was 31 minutes on one side and 27 minutes on the other side. Patients' postoperative courses were uneventful. The median postoperative hospital stay was 4 days. No postoperative complications occurred.ConclusionWhen used to treat benign gynecologic tumors and early stage gynecologic cancers, the single-site da Vinci robotic surgery is feasible, safe, and produces favorable surgical outcomes.

Da Vinci single site© surgical platform in clinical practice: a systematic review

“…Yoo et al . (2015) reported their successful experience with DVSSP for benign gynecologic tumors and early stage gynecologic cancers . Akdemir et al .…”

Single-Site Robotic Radical Hysterectomy and Sentinel Lymphnode Biopsy in Cervical Cancer: A Case Report

“…One by one, all of these few details compromise the surgeon's capability, leading to a decrease in performance and an increase in the risks. 15 Robotic surgery improved surgical gestures such as camera stability, less tremors, articulated instruments, and 3D visualization. Likewise, single-site robotic surgery developed not only with previous robotic characteristics, like a superior range of motion, but also by canceling the crossing effect of instruments.…”

Asian Society for Gynecologic Robotic Surgery consensus guidelines on robotic surgery in gynecological cancer

“…Tateo et al [54] presented one of the very first cases as a case report of robotic single-site pelvic lymphadenectomy in endometrial cancer. Yoo et al [55] reported six cases of early gynecologic cancer where the surgeons successfully completed systematic pelvic lymphadenectomies in four cases and described the technique in detail. Yoon et al [56] then demonstrated the feasibility of a hysterectomy, adnexectomy, and PLND on the SPRS platform.…”

“…This strength of this recommendation is MODERATE based on small case series and case demonstrations. The quality of the evidence supporting this recommendation is LOW [52][53][54][55][56][57]. 2) That with the introduction of even more robotic platforms that support single-port surgery, performance data, oncological outcomes, and value-outcome based evaluations be systematically collected, analyzed, and shared to validate SPRS for gynecological cancers.…”