Robotic Single-site Hysterectomy in Low Risk Endometrial Cancer: A Pilot Study

Abstract

To evaluate the feasibility and the safety of robotic single-site hysterectomy (RSSH) in low risk early endometrial cancer. Patients with clinical low risk early endometrial cancer were enrolled onto a prospective cohort trial. All surgical procedures were performed through a single 2-2.5cm umbilical incision, with a multichannel system consisting of a five-lumen port providing access for two single-site instruments (da Vinci Si Surgical System, Intuitive Surgical, Sunnyvale, CA), the 8.5mm 3D HD endoscope, a 5/10mm accessory port, and an insufflation adaptor. Between December 2011 and June 2012, a total of 17 patients were included in our pilot study. The median age of the patients was 64years (range, 42-84years), and median body mass index was 26.6kg/m(2) (range, 18-52kg/m(2)). One patient was excluded from the study as a result of pelvic metastasis during inspection of abdominal cavity, and another patient was converted to vaginal surgery as a result of problems of hypercapnia. The median docking time, console time, and total operative time was 8min (range, 5-14min), 48min (range, 45-51min), and 90min (range, 70-147min), respectively. The median blood loss was 75mL (range, 50-150mL). No laparoscopy/laparotomy conversion was registered. The median time to discharge was 2days (range, 1-3days). Neither intraoperative nor postoperative complications occurred. At a median of 7.5months' follow-up, all patients were disease-free. RSSH is technically feasible in patients affected by low risk early endometrial cancer. Additional studies with gynecologic oncologic cases should be performed to explore the possible benefits of RSSH.