A Comparative Analysis of Robotic Single-Site Surgery and Laparoendoscopic Single-Site Surgery as Therapeutic Options for Stage IB1 Cervical Squamous Carcinoma

Abstract

Purpose To compare perioperative outcomes between robotic single-site surgical technique and conventional laparoendoscopic single-site surgical technique. Methods This was a retrospective cohort study involving 67 patients who received robotic single-site surgery or laparoendoscopic single-site surgery for the treatment of stage IB1 cervical squamous carcinoma. The robotic single-site radical hysterectomy technique combined with pelvic lymph node dissections were performed in 32 patients while the laparoendoscopic single-site radical hysterectomy technique combined with pelvic lymph node dissections were performed in 35 patients. Results The enrolled patients had been diagnosed with stage IB1 cervical squamous carcinoma. The perioperative outcomes were mean age (51.63±8.32 years in the lymph node dissection (RSS group) and 53.14±8.14 years in the lymph node dissection (LESS group), p=0.453); BMIs (23.76±2.72 in the RSS group and 23.46±2.28 in the LESS group, p=0.629); shorter operative times (223.56±15.43 min in the RSS group and 248.61±20.89 min in the LESS group, p<0.01) and less estimated blood loss (217.25±16.77 mL in the RSS group and 294.74±24.00 mL in the LESS group, p<0.01). None of the study participants exhibited postoperative pain. There were no statistically significant differences in the length of hospital stay (p=0.865), perioperative complications (p=0.602), duration of closure and removal of catheter (p=0.518) as well as in pathological diagnoses between the two groups. Conclusion Robotic single-site surgery can be used in the treatment of early stage cervical cancer as it exhibits acceptable operative times and perioperative outcomes. This surgical technique is feasible and safe.

Role of transumbilical laparoendoscopic single-site surgery in the implementation of ERAS in gynecology oncology: a retrospective study

“…We found that the use of TU-LESS resulted in enhanced recovery for our patients; the surgical outcomes were also consistent with those of previous studies [24][25][26]. The rate of postoperative complications were slight higher than previous TU-LESS reports, since most reports focused on the benign lesions or others which focused on malignant disease with small sample size (2.7%-8.5%) [24,27,28]. Fagotti et al reported that with endometrial cancer surgery, the median operation time was 129 minutes, ranging from 45 to 321 minutes, and that estimated blood loss was 70 mL, ranging from 10 to 500 mL-since the majority of patients did not undergo lymphadenectomy.…”

“…We found that the use of TU-LESS resulted in enhanced recovery for our patients; the surgical outcomes were also consistent with those of previous studies [24][25][26]. The rate of postoperative complications were slight higher than previous TU-LESS reports, since most reports focused on the benign lesions or others which focused on malignant disease with small sample size (2.7%-8.5%) [24,27,28].…”

Surgical Outcomes Following Robotic Single-Site Versus Multiport Hysterectomy for Treatment of Endometrial Cancer: A Systematic Review and Meta-Analysis

“…In a study spanning various surgical specialties, laparoscopic procedures have been associated with reduced operating costs [8]. Similar studies have found improved total operating time and complication rates with a laparoscopic approach [9,10]. Research favoring a robotic approach has noted a decreased length of stay with this intervention [9].…”

Da Vinci SP Robotic Surgery for Cervical Cancer FIGO 2018 Stage IA-IB: A Pilot Study

“…Minimally invasive surgery (MIS) for early-stage cervical cancer undergoes progressive development and acceptance since assimilation of robotic technology into gynecologic cancer surgery in 2005. Patients undergoing robotic surgery have lesser operative complications, reduced estimated blood loss (EBL) and shorter postoperative hospital stay (POHS) [1][2][3][4]. From 3-robotic arm [2,5] to adding the 4th robotic arm [6], attempts have been made to re ne the practicality of robotic platform in surgery for cervical cancer.…”