The Experience of Robotic-Assisted Laparoscopic Hysterectomy for Women Treated for Early-Stage Endometrial Cancer

Abstract

Patient education about the normal postoperative course in regard to vaginal bleeding, bowel function, and level of physical activity is needed. Individualized information about anatomical changes after surgery is warranted, preferably using anatomical drawings. Potentially, the women could benefit from attending a nursing clinic during the first postoperative months.

Lymphedema after treatment for endometrial cancer − A review of prevalence and risk factors

“…In many of the studies the assessment of LLL was based on information retrieved from the medical records or from patient reported symptoms in the survey studies. The ISL 4-grade staging of lymphedema [26] has been used by some authors [21,24,[27][28][29], whereas others have used the National Cancer Institute Common Toxicity Criteria (NCI-CTC v2 [30]) [20,22,31,32] or the National Lymphedema Network [16] to grade the severity of lymphedema.…”

“…When comparing conventional LPS with robot-assisted LPS no difference in prevalence of LLL was found, 2% and 3%, respectively [53]. In four studies with only robotic surgery comprising pelvic and/or para-aortic LA [29,32,54,55], the LLL incidence was reported to be 5.2% to 21%, with a lower incidence, although not statistically significant, when the operation had been converted to LPT [54]. In all of these studies the diagnosis of LLL was based on information from the medical records, with no systematical measurements performed except in the study by Geppert et al [32] who used the NCI-CTC classification prospectively on those with symptomatic LLL but without baseline evaluation.…”

Complications of robotic-assisted laparoscopic surgery distant from the surgical site

“…65 Incidence of urogenital events focusing on kidney injury was reported in one retrospective study as 0.4% and noted acute tubular necrosis as a presumptive aetiology as a result of low blood flow. 71 This was considered to be more significant in the elderly, who may not possess the reserve to recover their renal function postoperatively as seen in younger subjects. 65 One case involved a non-oliguric renal failure, possibly because of rhabdomyolysis from compartment syndrome.…”

The evolution of robotic surgery: surgical and anaesthetic aspects

“…49 Current robotic surgical evidence points towards a convincing reduction in postoperative surgical and non-surgical complications, reduced blood loss, improved recovery rates, improved cosmesis and reduced length of stay in comparison with open surgery. [50][51][52] The comparison with MIS however is equivocal, although several studies do show some advantages in length of stay, conversion rate and estimated blood loss. [53][54][55] Concerns regarding robotic surgery predominantly focus on increased length of operating time (and cost), although gains in improved recovery times and benefits of robotic techniques in more complex surgery and with specialist groups may go some way to counter this.…”