Comparing Robotic Surgery With Conventional Laparoscopy and Laparotomy for Cervical Cancer Management

Chen, Ching Hui; Chiu, Li Hsuan; Chang, Ching Wen; Yen, Yuan Kuei; Huang, Yan; Liu, Weimin

doi:10.1097/igc.0000000000000160

Cited by 61 publications

(73 citation statements)

References 30 publications

(17 reference statements)

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“…These field [12]. Although no randomized control trials were used to compare these 2 surgical techniques, controlled clinical trials support the use of robotic surgery in treating cervical cancer and endometrial cancer [13][14][15]. Nonetheless, the overall efficacy of robotic surgery in treating ovarian and fallopian tube tumors remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Incidental Fallopian Tube Adenocarcinoma Managed using Robotic Staging Surgery

Hh³

et al. 2016

Adv Robot Autom

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IntroductionPrimary fallopian tube tumors, which are rare gynecological malignancies that account for 0.14%-1.8% of genital malignancy, mainly affect women aged 40-65 years [1]. Diagnosing primary fallopian tube tumors is challenging, and case reports involving tumors managed using robot-assisted staging surgery are rare. However, we have reported here two cases with favourable prognoses of primary fallopian tube tumors managed using robot-assisted staging surgery. The robotic-assisted procedures using three robotic arms were performed with the patient in the lithotomy position under general anesthesia. A uterine manipulator was put in place, and a pneumoperitoneum was obtained. For setting of the robotic surgery, a 12 mm camera port was set 6 cm above the umbilicus, and 8 mm trocars were set 8 to 10 cm caudal-lateral to the scope for the side arms at each side of the patient, respectively. We placed a fenestrated bipolar forcep in left arm for electrocoagulation and a monopolar curved scissor in right arm for simultaneous cutting and electro-cauterization. A manually operated accessory trocar, which was set at 6 to 8 cm caudal-lateral to the left arm, was placed for lymph node extraction.The robotic arms were docked smoothly, and ascites was collected for cytological examination. The robotic surgery was performed with Endo Wrist instruments including monopolar curved scissors and fenestrated bipolar forceps. A grasper was used via the accessory port to assist in the surgical procedures. A survey of the operative field and evaluation of pelvic adhesion were performed. A frozen section of the suspected primary lesion was sent to confirm its malignancy prior to the main procedure. Surgical staging procedures including a total hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic retroperitoneal lymph node dissection, para-aortic lymph node dissection, appendectomy, omentectomy, peritoneal biopsies, and ascites cytology were performed. After the main procedures, the uterus was removed intact via the vagina, and transvaginal suturing was performed subsequently to close the vaginal cuff. After surgery, the dissected tissue was subjected to pathological examination. Case 1A 49-year-old woman visited the author's clinic for abnormal vaginal discharge. She had not had a previous surgery or any family history of ovarian malignancy. She had menarche at the age of 13 and has had a regular menstrual cycle since then. She had given birth to two children and had never had an abortion. A transvaginal ultrasound preformed in the clinic revealed ascites and a left adnexal heteroechoic mass, 7 × 3 cm. A P ap smear report revealed atypical glandular cells. On admission to the obstetrics and gynecology ward, an abdominal examination did not reveal anything significant; no abdominal palpable mass, abdominal pain or enlargement of lymph nodes were noted. A vaginal examination presented a free range of motion for the cervix with serosanguinous vaginal discharge but without palpable adnexal mass lesions. A pelvic CT scan show...

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Section: Discussionmentioning

confidence: 99%

Incidental Fallopian Tube Adenocarcinoma Managed using Robotic Staging Surgery

Hh³

et al. 2016

Adv Robot Autom

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“…22,34 In addition to that, blood loss was highest when using traditional radical hysterectomy surgery with a mean blood loss of 450 to 1000 mL. 11,30,32,33 The reason for a decrease in blood loss during RRH surgery compared with TLRH is that the sacral afferent fibers and deep uterine veins can be more easily differentiated because of the robotic arm. In addition, the movement of the robotic arm results in stable traction and counter traction and excellent 3-dimensional view within a narrow space.…”

Section: International Journal Of Gynecologicalmentioning

confidence: 99%

“…14,34 Interestingly, we noticed that studies from the United States tend to have much shorter duration of hospitalization compared with all laparoscopic studies conducted in Asia including 3 studies from Korea and 1 from Taiwan. 11,12,37 Maybe this is because of societal differences, because cancer patients in Asia tend to stay longer in the hospital because of national health insurance subsidies as suggested by Chen et al 11 The dissection of pelvic lymph nodes during radical hysterectomy is critical for the outcome of the patient.…”

Section: International Journal Of Gynecologicalmentioning

confidence: 99%

“…31,32 In contrast to this, there were also several other studies that had a much longer operating time in the RRH group compared with our study. 11,22 Thus, the duration of the operating time is quite variable as the definition of ''operating time'' differs between studies. 7 Therefore, the lack of standardization of the term operating time makes it complicated to draw comprehensive conclusions from this outcome alone.…”

Section: International Journal Of Gynecologicalmentioning

confidence: 99%

“…The increase in lymph node counts that are dissected during RRH or TLRH procedures compared with the traditional hysterectomy is due to an increased precision with the laparoscope or robotic arm and is beneficial for the patient. 11 Lastly, we also assessed the frequency of relapse or deaths in RRH and TLRH treated patients. Our results reveal that the follow-up was significantly better in the RRH group compared with the TLRH group with no reported relapses in the robotic arm.…”

Section: Y40mentioning

confidence: 99%

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Robotic-Assisted Radical Hysterectomy Results in Better Surgical Outcomes Compared to the Traditional Laparoscopic Radical Hysterectomy for the Treatment of Cervical Cancer

Nie

Liu

2017

Journal of Minimally Invasive Gynecology

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Objective: The aim of this study was to compare the surgical outcomes of robotic-assisted radical hysterectomy (RRH) with traditional laparoscopic radical hysterectomy (TLRH) for the treatment of early-stage cervical cancer in a large retrospective cohort of a total of 933 patients. Methods: We have enrolled 100 patients into the RRH and 833 patients into the TLRH group. The surgical outcomes include operating time, blood loss, transfusion rate, pelvic lymph node yield, hospitalization days, duration of bowel function recovery, catheter removal before and after 3 weeks, conversion to laparotomy, and intraoperative and postoperative complications. Follow-up results were also analyzed for all patients. Results: Both groups have similar patient and tumor characteristics but patients with a larger lesion size were preferably enrolled in the TLRH treatment group. The treatment with RRH was generally superior to TLRH with respect to operating time, blood loss, length of hospitalization, duration of bowel function recovery, and postoperative complications. On follow-up of patients, there were no relapses reported in the RRH group compared with 4% of relapse cases and 2.9% of deaths because of metastasis in the TLRH group. No conversion of laparotomy occurred in the RRH group. No significant difference was found with respect to intraoperative complications and blood transfusion between both groups. Conclusions: The results from this study suggest that RRH is superior to TLRH with regard to surgical outcome and may pose a safe and feasible alternative to TLRH. The operating time and lymph node yield is acceptable. Our study is one of the largest single-center studies of surgical outcomes comparing RRH with TLRH during cervical cancer treatment and will significantly contribute to the safety of alternative treatment options for patients. Furthermore, the difference detected between TLRH and RRH group is further strengthened by the great expertise of the surgeon performing laparoscopic surgeries.

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Fertility‐sparing and minimally invasive surgery for early‐stage cervical cancer

Shvygin,

Manning‐Geist,

Sonoda

2023

Journal of Surgical Oncology

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Comparing Robotic Surgery With Conventional Laparoscopy and Laparotomy for Cervical Cancer Management

Abstract: The data suggested that robotic surgery is a feasible and potentially optimal option for the treatment of stage IA to IIB cervical cancer with favorable short-term surgical outcomes.

Cited by 61 publications

References 30 publications

Incidental Fallopian Tube Adenocarcinoma Managed using Robotic Staging Surgery

Incidental Fallopian Tube Adenocarcinoma Managed using Robotic Staging Surgery

Robotic-Assisted Radical Hysterectomy Results in Better Surgical Outcomes Compared to the Traditional Laparoscopic Radical Hysterectomy for the Treatment of Cervical Cancer

Fertility‐sparing and minimally invasive surgery for early‐stage cervical cancer

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