Robot assisted surgery in gynaecologic oncology - starting a program and initial learning curve from a UK tertiary referral centre: the Guildford perspective

Abstract

The paper discusses the setup and evaluation of early data following the establishment of a robotic surgery programme in a UK gynaecological oncology cancer centre. Prospective data were collected between December 2009 and December 2011 for all women undergoing robotic assisted procedures within the gynaecological oncology department. Patient demographics, intra, peri and post-operative data were collected at a single institution, which is a tertiary referral centre for gynaecological oncology and minimal access surgery. In total, 104 robotically assisted cases were performed within the gynaecological oncology team. The procedures undertaken included simple and radical hysterectomy, radical trachelectomy, BSO following previous hysterectomy, pelvic and para-aortic node dissection and omentectomy. The mean blood loss was 155.24 mL and the mean hospital stay was 3 days with more than half the women being discharged on day 1 post surgery. These data suggest that robotic assisted surgery is well suited to treating women with principally endometrial and cervical cancers and selected cases of ovarian cancer, enabling surgical staging to be completed with many more patients benefitting from a minimal access surgery approach. Thorough preparation, appropriate case selection and preceptorship in robotic surgery is essential to minimize the associated risks associated with adopting new surgical techniques.