Robotic single site staging in endometrial cancer: A multi-institution study

Abstract Objective To evaluate the feasibility and the safety of robotic single-site hysterectomy (RSSH) plus or less pelvic lymphadenectomy in FIGO stage I-II endometrial cancer. Materials and Methods We prospectively collected patient demographics, operative times, complications, pathologic results, and length of stay on all patients who underwent robotic single site hysterectomy plus or less pelvic lymphadenectomy for clinical FIGO stage I or occult stage II endometrial carcinoma. Results From January 2012 to February 2015, 125 patients were included in our study. The median age of the patients was 59 years (range, 35–84 years) and the median body mass index was 27kg/m2 (range, 19–52kg/m2 ). One patient was converted to vaginal surgery due to problems of hypercapnia. The median docking time, console time, and total operative time was 11 minutes (range, 4–40 minutes), 80 minutes (range, 20–240 minutes) and 122 minutes (range, 35–282 minutes), respectively. The median blood loss was 50mL (range, 10–250mL). No laparoscopic/laparotomic conversion was registered. Twenty one patients underwent pelvic lymphadenectomy (16.8%) and the median pelvic lymph nodes was 13 (range, 3-32). The median time to discharge was 2 days (range, 1 to 3 days). No intra-operative complications occurred, while we observed 10 (8%) early post-operative complications. Conclusion RSSH plus or less pelvic lymphadenectomy is technically feasible, safe and reproducible and could be the treatment of choice for patients affected by FIGO stage I-II endometrial cancer. However, randomized controlled trials are needed to confirm these results.