Robotic Surgery: Changing the Surgical Approach for Endometrial Cancer in a Referral Cancer Center

Study Objective: To study the effect of robotic surgery on the surgical approach to endometrial cancer in a gynecologic oncology center over a short time. Design: Prospective analysis of patients with early-stage endometrial cancer who underwent robotic surgery. Setting: Teaching hospital. Patients: Eighty patients who underwent robotic surgery. Interventions: Between November 2006 and October 2008, 80 consecutive patients with an initial diagnosis of endometrial cancer consented to undergo robotic surgery at the European Institute of Oncology, Milan, Italy. Measurements and Main Results: We collected all patient data for demographics, operating time, estimated blood loss, histologic findings, lymph node count, analgesic-free postoperative day, length of stay, and intraoperative and early postoperative complications. Mean (SD) patient age was 58.3 (11.5) years (95% confidence interval [CI], 55.7-60.9). Body mass index was 25.2 (6.1) kg/m2 (95% CI, 23.6-26.7). In 3 patients (3.7%), conversion to conventional laparotomy was required. Mean operative time was 181.1 (63.1) minutes (95% CI, 166.7-195.5). Mean docking time was 4.5 (1.1) minutes (95% CI, 2.2-2.7). Mean hospital stay was 2.5 (1.1) days (95% CI, 2.2-2.7), and 93% of patients were analgesic-free on postoperative day 2. Conclusions: Over a relatively short time using the da Vinci surgical system, we observed a substantial change in our surgical activity. For endometrial cancer, open surgical procedures decreased from 78% to 35%. Moreover, our preliminary data confirm that surgical robotic staging for early-stage endometrial cancer is feasible and safe. Age, obesity, and previous surgery do not seem to be contraindications