Robotic-assisted vs traditional laparoscopic surgery for endometrial cancer: a randomized controlled trial

Mäenpää, Minna; Nieminen, Kari; Tomás, Eija; Laurila, Marita; Luukkaala, Tiina; Mäenpää, Johanna

doi:10.1016/j.ajog.2016.06.005

Cited by 137 publications

(74 citation statements)

References 28 publications

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“…3 In this regard, it should be interesting to see whether both surgical approaches are similar or not when well-trained surgeons, either in conventional laparoscopy or robotic surgery, perform the same complex procedures. To date, only 1 small randomized controlled trials has been performed in women with endometrial cancer, and it compared 49 women treated by conventional laparoscopy 20 The implementation of MIS for patients with gynecological cancer may vary according to the availability of robotic technology as well as surgeon expertise. In some institutions, the introduction of robotic-assisted laparoscopy allowed to expand the application of MIS in patients with gynecological cancer, 52Y54 even in cases of obese patients, because of a shorter learning curve.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery to Treat Gynecological Cancer

Minig

Achilarre

Garbi

et al. 2017

International Journal of Gynecological Cancer

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Robotic-assisted surgery is a technological advancement derived from conventional laparoscopy, which facilitates the application of minimally invasive techniques for complex operations in the field of gynecological oncology. However, its introduction in gynecological cancer has been scarce in most hospitals worldwide. Most publications on robotic surgery are still retrospective or descriptive in nature. Some studies compare robotic-assisted laparoscopy with open procedures, which is a questionable analysis, because the advantages of minimally invasive surgery have been already well established. Robotic surgery should be directly compared with conventional laparoscopy to determine whether its additional direct and indirect costs are in accordance with some improvements within patient clinical outcomes. On the other hand, the role of robotic-assisted surgery in allowing more patients to receive the benefits of the minimally invasive approach should also be considered. The objective of this article was, therefore, to review the literature regarding the role of conventional and robotic-assisted laparoscopy to treat women with gynecologic cancer.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery to Treat Gynecological Cancer

Minig

Achilarre

Garbi

et al. 2017

International Journal of Gynecological Cancer

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“…The details of the study population, randomization procedure, and operations have been described in detail previously. 4 The operations were performed at a tertiary referral center, the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland from 2010 to 2013 by gynecologic oncologists with several years of experience with laparoscopic surgery. The study protocol was approved by the Research Ethics Committee of Tampere University Hospital (identification code ETL R10081) and is registered at www.clinicaltrials.gov (NCT 01466777).…”

Section: Methodsmentioning

confidence: 99%

“…Because of swelling in lower extremities, many patients underwent a Doppler ultrasound imaging to exclude deep venous thrombosis with no findings. 4 Public health care in Finland uses an internal accounting and billing system within the hospitals. Different hospital units offer services based on their expertise such as anesthetic services, operating room (OR) services, laboratory services, and consultations provided by other specialties like urologic surgery.…”

Section: Methodsmentioning

confidence: 99%

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Costs of Robotic-Assisted Versus Traditional Laparoscopy in Endometrial Cancer

Vuorinen

Mäenpää

Nieminen

et al. 2017

International Journal of Gynecological Cancer

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“…Robotic surgery achieved equivalent or better oncological results compared to laparoscopy. A Finnish investigation of 99 patients revealed no difference in the number of resected lymph nodes; but robotic surgery was associated with shorter operating times, fewer conversions to laparotomy, as well as fewer minor and major complications (31). In an American study, the robotassisted approach was found to be superior to the laparoscopic approach (32).…”

Section: Application In Malignant Gynecological Diseasementioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

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Review 224 Robotic surgery in gynecologyRobotic surgery is a dynamic development for minimally invasive procedures. The specialty of gynecology consistently offers new opportunities for innovative surgical techniques and the advancement of existing therapy approaches (Figure 1). Ever since the American FDA granted approval of the Da Vinci operation robot for gynecological operations in 2005, about three million robotic operations have been performed worldwide. 3500 Da Vinci systems are currently in use: 586 of these in Europe and 77 in Germany (4 th quarter of 2015). According to the figures of Intuitive Surgical, about 600,000 interventions were performed on a worldwide basis in the year 2014, of which 50% were performed in gynecology, approximately 30% in urology, and about 20% in general and chest surgeries. In 2011, the proportion of robotic hysterectomies performed for benign indications in the USA was as high as 27% (1). Currently, we have experience in robotic surgery for the majority of gynecological operations and fields of application. The known advantages of minimally invasive surgery, such as less blood loss, shorter durations of hospital stay, and lower patient morbidity compared to open procedures, have been observed here as well. Better exposure of the operating field by 3D technology and the extension of surgical instruments to 7 degrees of freedom permit the use of minimally invasive surgery, even for complex indications. Robot-assisted manipulation of the instruments permits tremor-free handling and reduces work fatigue for the surgeon, which is very advantageous for the surgeon as well as the patient in long and complex interventions. The possibility of working simultaneously on two parallel consoles shortens the learning curve, reduces complication rates, and facilitates the training of surgeons (2). The advancement of robotic surgery in terms of the Da Vinci Xi permits the variable use of optics in all four trocars (paraaortic lymphadenectomy, omentectomy, or interdisciplinary surgery in the upper abdomen can be performed without re-docking) and ensures markedly greater flexibility due to the optimized geometry of the so-called patient cart. Robotic surgery has been criticized for the fact that it requires the use of larger trocars compared to conventional laparoscopy, and is therefore associated with more numerous and larger cosmetic scars; this is avoided by the smaller trocars now used in robotic surgery (3). The development of the single-site systems signifies further new options for the gynecological surgeon (Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4, 5). The low level of postoperative pain appears to be another advantage. It is accompanied by a lesser need for analgesics and even shorter hospital stays compared to traditional laparoscopic surgery. One explanation could be the fact that the abdominal wall need not be used as a counter bearing. The absence of irritation and the advantage of tissue protec...

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Robotic-assisted vs traditional laparoscopic surgery for endometrial cancer: a randomized controlled trial

Cited by 137 publications

References 28 publications

Minimally Invasive Surgery to Treat Gynecological Cancer

Minimally Invasive Surgery to Treat Gynecological Cancer

Costs of Robotic-Assisted Versus Traditional Laparoscopy in Endometrial Cancer

Robotic surgery in gynecology

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