Robotic surgery for early stage cervical cancer: Evolution and current trends

Medlin, Erin; Kushner, David M.; Barroilhet, Lisa

doi:10.1002/jso.24008

Cited by 16 publications

(10 citation statements)

References 102 publications

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“…The information on outcomes is limited to cases with common cervical carcinoma histology. Radical trachelectomy (RT), a valid alternative to radical hysterectomy, can be performed vaginally, abdominally, or endoscopically in patients with FIGO stage IA−IB cervical cancer (lesion ≤2 cm without extension to internal os/low segment) who want to preserve fertility [ 16 – 18 ]. The abdominal route is optimal when vaginal access is not possible in nulligravida women, as it allows surgeons to obtain more parametrium than that via the vaginal route.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 9% of patients had cervical stenosis [ 8 , 17 ], and the recurrence rate after ART was 0–4.8%, while the pregnancy rate after ART was 15.5–44% [ 7 , 8 ]. The safety and feasibility of laparoscopic and robotic RT have been documented [ 18 ]. Compared with ART, laparoscopic and robotic approaches result in less blood loss, shorter hospital stays, comparable cancer recurrence rates, and similar operative outcomes [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Case report: term birth after fertility-sparing treatments for stage IB1 small cell neuroendocrine carcinoma of the cervix

Cheng

Huey

et al. 2017

BMC Women's Health

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BackgroundAdvances in cervical cancer management for childbearing women have led to less radical approaches. Use of fertility-sparing treatment to treat small cell neuroendocrine carcinoma (SCNEC) is challenging owing to the aggressive nature of the disease, even in early stage disease.Case presentationA 25-year-old nulligravida woman presented with malodorous vaginal discharge and was diagnosed to have an exophytic cervical SCNEC. A magnetic resonance image scan showed no evidence of parametrial invasion or distant metastasis. Clinical staging allocated her to stage IB1 disease. She underwent radical abdominal trachelectomy for reproductive purpose. Preoperative and postoperative chemotherapy with ifosfamide/etoposide/cisplatin combining gonadotropin-releasing hormone agonist were administered. She had a spontaneous, uneventful pregnancy and successfully delivered a term baby via cesarean section 7 years after treatment.ConclusionTo our knowledge, we describe the first success in offering a fertility-preserving multimodality strategy to present favorable oncologic, reproductive, and obstetric outcomes in a fertile woman of stage I SCNEC. Individualized multimodality therapy may be utilized in specific patients with early-stage cervical cancer to preserve their fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: term birth after fertility-sparing treatments for stage IB1 small cell neuroendocrine carcinoma of the cervix

Cheng

Huey

et al. 2017

BMC Women's Health

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“…[5,6] An increasing number of studies have reported the benefits of robotic radical hysterectomy (RRH) including better ergonomics, higher definition, the ability to see in 3-dimensionals, 7° of wrist-like motion, tremor filtering, motion scaling, and less fatigue. [7]…”

Section: Introductionmentioning

confidence: 99%

Efficacy of robotic radical hysterectomy for cervical cancer compared with that of open and laparoscopic surgery

Zhang

Ding²,

Cui³

et al. 2019

Medicine

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Background:To perform a meta-analysis of high-quality studies comparing robotic radical hysterectomy (RRH) vs laparoscopic radical hysterectomy (LRH), and open radical hysterectomy (ORH) for the treatment of cervical cancer.Methods:A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was performed to identify studies that compared RRH with LRH or ORH. The selection of high-quality, nonrandomized comparative studies was based on a validated tool (methodologic index for nonrandomized studies) since no randomized controlled trials have been published. Outcomes of interest included conversion rate, operation time, intraoperative estimated blood loss (EBL), length of hospital stay (LOS), morbidity, mortality, number of retrieved lymph nodes (RLNs), and long-term oncologic outcomes.Results:Twelve studies assessing RRH vs LRH or ORH were included for this meta-analysis. In comparison with LRH, there was no difference in operation time, EBL, conversion rate, intraoperative or postoperative complications, LOS, and tumor recurrence (P > .05). Compared with ORH, patients underwent RRH had less EBL (weighted mean difference [WMD] = −322.59 mL; 95% confidence interval [CI]: −502.75 to −142.43, P < .01), a lower transfusion rate (odds ratio [OR] = 0.14, 95% CI: 0.06–0.34, P < .01), and shorter LOS (WMD = −2.71 days; 95% CI: −3.74 to −1.68, P < .01). There was no significant difference between RRH and LRH with respect to the operation time, intraoperative or postoperative complications, RLN, and tumor recurrence (P > .05).Conclusion:Our results indicate that RRH is safe and effective compared to its laparoscopic and open counterpart and provides favorable outcomes in postoperative recovery.

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“…Despite the fact that robot-assisted laparoscopic surgery can provide value in many surgical applications (e.g., gynecologic, 1 liver, 2 and rectal 3 surgery), it is still most commonly used for the surgical management of prostate cancer. 4 In addition to the removal of the primary prostate cancer (prostatectomy), such procedures are often accompanied by a form of lymph node dissection focused on the removal of lymphatic metastases, e.g., a (extended) lymphadenectomy, a sentinel node (SN) procedure, 5 or, in the future, a prostate-specific membrane antigentargeted nodal dissection.…”

Section: Introductionmentioning

confidence: 99%

Navigation of a robot-integrated fluorescence laparoscope in preoperative SPECT/CT and intraoperative freehand SPECT imaging data: a phantom study

et al. 2016

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Robot-assisted laparoscopic surgery is becoming an established technique for prostatectomy and is increasingly being explored for other types of cancer. Linking intraoperative imaging techniques, such as fluorescence guidance, with the three-dimensional insights provided by preoperative imaging remains a challenge. Navigation technologies may provide a solution, especially when directly linked to both the robotic setup and the fluorescence laparoscope. We evaluated the feasibility of such a setup. Preoperative single-photon emission computed tomography/X-ray computed tomography (SPECT/CT) or intraoperative freehand SPECT (fhSPECT) scans were used to navigate an optically tracked robot-integrated fluorescence laparoscope via an augmented reality overlay in the laparoscopic video feed. The navigation accuracy was evaluated in soft tissue phantoms, followed by studies in a human-like torso phantom. Navigation accuracies found for SPECT/CT-based navigation were 2.25 mm (coronal) and 2.08 mm (sagittal). For fhSPECT-based navigation, these were 1.92 mm (coronal) and 2.83 mm (sagittal). All errors remained below the <1-cm detection limit for fluorescence imaging, allowing refinement of the navigation process using fluorescence findings. The phantom experiments performed suggest that SPECT-based navigation of the robot-integrated fluorescence laparoscope is feasible and may aid fluorescence-guided surgery procedures.

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Robotic surgery for early stage cervical cancer: Evolution and current trends

Cited by 16 publications

References 102 publications

Case report: term birth after fertility-sparing treatments for stage IB1 small cell neuroendocrine carcinoma of the cervix

Case report: term birth after fertility-sparing treatments for stage IB1 small cell neuroendocrine carcinoma of the cervix

Efficacy of robotic radical hysterectomy for cervical cancer compared with that of open and laparoscopic surgery

Navigation of a robot-integrated fluorescence laparoscope in preoperative SPECT/CT and intraoperative freehand SPECT imaging data: a phantom study

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