Hand-assisted Robotic Approach for Ovarian Cancer Management

Cindy Chan,Li Hsuan Chiu,Wei Min Liu,Ching Hui Chen

doi:10.4172/2168-9695.1000159

Abstract

Robotic assisted staging surgery has been increasingly employed for a variety of gynecological malignancies such as ovarian, endometrial, and cervical cancers. Here we demonstrate a hand-assisted robotic approach for managing ovarian cancer with large tumor mass and predominantly solid components, where mini-laparotomy is performed followed by robotic surgical staging procedures. In this retrospective descriptive analysis of 29 ovarian cancer patients, admitted from December 2011 to May 2014, who had a large tumor mass (≥ 7 cm) and received laparoscopic surgical staging, traditional robotic surgical staging or hand-assisted robotic procedures, we reviewed for patient demographics, surgical procedures, and perioperative parameters. The results were comparable and we conclude the hand-assisted robotic approach offers a safe and feasible way to perform ovarian cancer surgical staging for patients with large tumor masses.

Highlights

Since its introduction in 2005, robotic assisted surgical procedures have been widely adopted by gynecologists to perform surgical procedures such as cystectomies, sacral colpopexies, myomectomies, radical hysterectomies and cancer staging surgeries [1,2,3,4,5,6]
Our results show that many perioperative parameters of the hand-assisted robotic staging surgery group are comparable to the traditional robotic-assisted staging surgery group
Considering the hand-assisted robotic approach includes a laparotomy wound, it was expected that operation time, pain scores or length of hospital stay would differ from the traditional robotic approach, but our data showed that both groups had similar results in these categories

Summary

Introduction

Since its introduction in 2005, robotic assisted surgical procedures have been widely adopted by gynecologists to perform surgical procedures such as cystectomies, sacral colpopexies, myomectomies, radical hysterectomies and cancer staging surgeries [1,2,3,4,5,6]. Robotic assisted staging surgery has been increasingly employed for a variety of gynecological malignancies such as ovarian, endometrial, and cervical cancers. The overall 5-year survival rate of ovarian cancer is 43% [11], and when the disease is diagnosed in the early stages, the survival rate can be as high as 94% [12]. For management at advanced stages, exploratory or extensive dissection of lesion sites in the abdomen and pelvis is required. With such cases, comprehensive surgical staging using robotic or laparoscopic procedures are thought to be difficult [13]. Robotic assisted surgery for these advanced cases faces obstacles such as difficulty removing large tumor masses without rupture into the peritoneal cavity and limited access to upper abdominal quadrants when disease is diffuse

Methods

Results

Conclusion