Survey of current practices and opinions of German Society of Gynecologic Endoscopy members regarding the treatment of ovarian neoplasia by robotic surgery

Zimmermann, Julia; Radosa, Julia Caroline; Radosa, MP; Sklavounos, P; Schweitzer, P. A.; Solomayer, Erich‐Franz

doi:10.1007/s00404-020-05876-w

Cited by 5 publications

(4 citation statements)

References 47 publications

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“…In addition, laparoscopy has been associated with a higher rate of intraoperative cyst rupture, resulting in upstaging [23]. Other points of concern may include the occurrence of port-site metastasis, although this risk is considered to be low for early-stage ovarian cancer, and the controversial potential impacts of pneumoperitoneum on intra-abdominal tumor cell carryover and growth factor production [24,25]. Several retrospective studies have shown that the application of laparoscopy in the treatment of early ovarian cancer is safe and feasible.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Fertility-Sparing Surgery for Early Ovarian Malignancies

Zimmermann,

Ramisch,

Radosa

et al. 2023

Cancers

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The demand for fertility-sparing surgery (FSS) has increased in the last decade due to increased maternal age, increased incidence of ovarian malignancies in younger patients, and technical advances in surgery. Data on oncological safety and fertility outcomes of patients with ovarian cancer after laparoscopic FSS are sparse, but some retrospective studies have shown that open FSS may be offered to selected patients. We assessed the role of minimally invasive FSS in comparison with radical surgery (RS) in terms of oncological safety and reproductive outcomes after FSS in this multicenter study. Eighty patients with FIGO stage I/II ovarian cancer treated with laparoscopic FSS or RS between 01/2000 and 10/2018 at the participating centers (comprehensive gynecological cancer centers with minimally invasive surgical expertise) were included in this retrospective analysis of prospectively kept data. Case–control (n = 40 each) matching according to the FIGO stage was performed. Progression-free survival [150 (3–150) and 150 (5–150) months; p = 0.61] and overall survival [36 (3–150) and 50 (1–275) months; p = 0.65] did not differ between the FSS and RS groups. Eight (25.8%) women became pregnant after FSS, resulting in seven (22.5%) deliveries; three (37.5%) patients conceived after in vitro fertilization, and five (62.5%) conceived spontaneously. Laparoscopic FSS seems to be applicable and oncologically safe for patients with early-stage ovarian cancer, with adequate fertility outcomes.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Fertility-Sparing Surgery for Early Ovarian Malignancies

Zimmermann,

Ramisch,

Radosa

et al. 2023

Cancers

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“…Das Patientinnenalter stellte keine Kontraindikation für robotische gynäkologische Chirurgie dar. The use of robotic-assisted surgical systems, which represents a technological advance in minimally invasive surgery, is becoming increasingly popular among gynecological surgeons in Europe [1]. While robotic assistance is already widely used in gynecologicaloncological surgery [2,3], it is now increasingly being used in the surgical treatment of complex benign gynecological diseases, for procedures requiring extensive suturing [4], in obese female patients, or in patients who have had multiple previous abdominal operations [5,6].…”

Section: Zusammenfassungmentioning

confidence: 99%

“…Aus diesem Grund sollten auch operative Therapieoptionenwenn indiziertaus Altersgründen per se nicht infrage gestellt werden. Der Einsatz eines roboterassistierten Operationssystems als technologische Weiterentwicklung in der minimalinvasiven Chirurgie erreicht zunehmende Popularität unter den operativen Gynäkologen Europas [1]. Während robotische Assistenz in der gynäkoonkologischen Chirurgie bereits verbreitet ist [2,3], findet sie Einzug in die operative Behandlung komplexer benigner gynäkologischer Entitäten, bei nahtintensiven Prozeduren [4], bei adipösen Patientinnen oder nach multiplen abdominalen Voroperationen [5,6].…”

Section: Introductionunclassified

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Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes

Mothes

Kather

Cepraga

et al. 2023

Geburtshilfe Frauenheilkd

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Study design Because of current demographic developments, a hypothesis was proposed whereby older female patients aged > 65 years can be safely operated using minimally invasive, robotic-assisted surgery, despite having more preoperative comorbidities. A comparative cohort study was designed to compare the age group ≥ 65 years (older age group, OAG) with the age group < 65 years (younger age group, YAG) after robotic-assisted gynecological surgery (RAS) in two German centers. Patients and methods Consecutive RAS procedures performed between 2016 and 2021 at the Women’s University Hospital of Jena and the Robotic Center Eisenach to treat benign or oncological indications were included in the study. The age groups were compared according to their preoperative comorbidities (ASA, Charlson comorbidity index [CCI], cumulative illness rating scale – geriatric version [CIRS-G]) and perioperative parameters such as Clavien-Dindo (CD) classification of surgical complications. Analysis was performed using Welch’s t-test, chi2 test, and Fisher’s exact test. Results A total of 242 datasets were identified, of which 63 (73 ± 5 years) were OAG and 179 were YAG (48 ± 10 years). Patient characteristics and the percentage of benign or oncological indications did not differ between the two age groups. Comorbidity scores and the percentage of obese patients were higher in the OAG group: CCI (2.7 ± 2.0 vs. 1.5 ± 1.3; p < 0.001), CIRS-G (9.7 ± 3.9 vs. 5.4 ± 2.9; p < 0.001), ASA class II/III (91.8% vs. 74.1%; p = 0.004), obesity (54.1% vs. 38.2%; p = 0.030). There was no difference between age groups, even grouped for benign or oncological indications, with regard to perioperative parameters such as duration of surgery (p = 0.088; p = 0.368), length of hospital stay (p = 0.786; p = 0.814), decrease in Hb levels (p = 0.811; p = 0.058), conversion rate (p = 1.000; p = 1.000) and CD complications (p = 0.433; p = 0.745). Conclusion Although preoperative comorbidity was higher in the group of older female patients, no differences were found between age groups with regard to perioperative outcomes following robotic-assisted gynecological surgery. Patient age is not a contraindication for robotic gynecological surgery.

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