The role of robotic surgery in gynaecological oncology

PURPOSE: Laparoscopic surgery has been shown to be safe and feasible whilst treating patients with the same efficacy as traditional open procedures representing an acceptable approach in treating gynaecologic malignancies. However, the laparoscopic approach encountered some limitations: counterintuitive hand movements, two-dimensional visualization and limited degrees of instrument motion within the body. Robotic surgery overcomes many of the difficulties associated with conventional laparoscopy and allows surgeons to perform more complex procedures, whilst providing patients the benefits of minimally invasive surgery: radical hysterectomy with pelvic lymphadenectomy, trachelectomy and pelvic exenteration. MATERIAL AND METHODS: From March 2008 to April 2009, in our institution 19 patients underwent robotic radical hysterectomy with pelvic lymphadenectomy. Twelve patients were diagnosed with advanced cervical cancer, the rest of them with endometrial cancer. RESULTS: The mean operative time was 180 ± 23.45 min., the oral intake was started the next day after the operation and the patients were discharged 3.5 (±1.2) days postoperatively. CONCLUSION: As with any new procedure, careful patient selection is critical during the initial learning phase in order to progress through the learning curve with low morbidity and good outcomes. Robotic surgery is a viable option for many patients diagnosed with gynaecological cancers.