Combined robotic and vaginal approach in radical hysterectomy for the patient with bulky cervical cancer

Abstract

Objectives: Robotic surgery is gradually being incorporated into gynecologic oncology. Robotic radical hysterectomy offers some advantages over other surgical approaches with respect to operative time, blood loss, and hospital stay. Due to the necessary location of the robot docking system, however, there is not enough space to enable the performance of vaginal procedures. Therefore, robotic-assisted total radical hysterectomy is in the mainstream for early-stage cervical cancer treatment. In bulky cervical cancer, however, intrauterine manipulation is difficult to install and increases the risk of intra-abdominal tumor seeding. Especially difficult is determination of the level of vaginal cutting. For this reason, the vaginal approach is preferred for robot-assisted radical hysterectomy in bulky cervical cancer.