Abstract

BackgroundIn the last few decades, the introduction of technologies such as single-site surgery, robotics, and sentinel lymph node detection has reduced invasiveness in the treatment and staging of endometrial cancer patients. The goal of the present prospective cohort study is to evaluate the feasibility of lymph node fluorescence detection with robotic single-site approach in low-risk endometrial cancer.ResultsFifteen non consecutive low-risk endometrial atypical hyperplasia (EAH) patients underwent sentinel lymph node (SLN) biopsy and total hysterectomy utilizing the Da Vinci Si Single-Site Surgical. System and Firefly 3D imaging. Indications for surgery included eight (53.3%) IA FIGO stage G1 EC, three (20%) IA FIGO stage G2 EC, and four (26.6%) EAH. Mean operative time was 155 min (range 112–175). One vaginal laceration was the only perioperative complication encountered, and all patients were discharged within 48 h of surgery.SLN was detected in 86.6% of cases; 1/29 (3.4%) SLN results were positive for isolated tumor cells (ITCs) at immunohistochemical analysis.ConclusionsThe present study demonstrates the feasibility and applicability of robotic single-site approach with SLN fluorescence detection for the staging of low-risk endometrial cancer.

Highlights

  • In the last few decades, the introduction of technologies such as single-site surgery, robotics, and sentinel lymph node detection has reduced invasiveness in the treatment and staging of endometrial cancer patients

  • The aim of this study is to evaluate the feasibility of robotic single-site hysterectomy (RSSH) plus sentinel node biopsy for the staging of endometrial endometrioid cancer

  • This is a prospective, cohort study on nonconsecutive low-risk endometrial cancer patients treated with RSS hysterectomy plus bilateral salpingo-oophorectomy and sentinel lymph node (SLN) detection with the da Vinci Si Surgical System

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Summary

Introduction

In the last few decades, the introduction of technologies such as single-site surgery, robotics, and sentinel lymph node detection has reduced invasiveness in the treatment and staging of endometrial cancer patients. The goal of the present prospective cohort study is to evaluate the feasibility of lymph node fluorescence detection with robotic single-site approach in low-risk endometrial cancer. The surgical treatment of endometrial cancer has quickly evolved since the late 1980s with the introduction of laparoscopy. The laparoendoscopic single-site surgery (LESS) is an alternative to conventional laparoscopic or robotic surgery, as it provides the improved cosmetic benefits of minimally invasive surgery while avoiding the potential morbidity related to multiple incisions. The combination of robotics and single-site surgery appears to be the perfect fusion between the two techniques, enhancing the advantages and reducing the limitations

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