Robot-assisted laparoscopic hysterectomy. First experience

Close metadata

OBJECTIVE

The aim of the study is analysis of the results of robot-assisted laparoscopic hysterectomy.

MATERIAL AND METHODS

In the Oncology Clinic, a robot hysterectomy was performed in 24 patients aged 41 to 80 years. Inclusion criteria for robotic surgery were: a tumor size of more than 3 cm or more, the most common histological types and the absence of medical conditions that would be a contraindication. All interventions were performed on a DaVinchi system. Previously performed abdominal surgery was not a contraindication. Before the intervention, the diagnosis in all cases was histologically verified. All patients were examined for distant metastases.

RESULTS

The duration of the intervention, the length of hospitalization and the postoperative period, intra and postoperative complications were evaluated. The duration of surgery was an average of 90 minutes. The volume of intraoperative blood loss ranged from 50 to 100 ml. No intraoperative complications and conversions were noted. There were no complications in the postoperative period. An extract from the hospital was carried out on the 3-4th day.

CONCLUSION

Robot-assisted interventions in gynecology are highly effective. Further immediate and long-term outcomes of the intervention are required.

Keywords:

hysterectomy

laparoscopy

robotic-assisted operations

Authors:

Krasilnikov S.E.

Novosibirsk State Medical University of the Ministry of Health of Russia;
Academician E.N. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation

Drobayzgin E.A.

Novosibirsk State Medical University;
Novosibirsk State Regional Clinical Hospital;
Meshalkin National Medical Research Center

ORCID: 0000-0002-3690-1316

Pogrebnitskiy K.A.

Meshalkin National Medical Research Center

Taranov P.A.

Meshalkin National Medical Research Center

Krylyshkin M.I.

Meshalkin National Medical Research Center

Received:

04.07.2022

Accepted:

14.07.2022

List of references:

Li G, Yan X, Shang H, Wang G, Chen L, Han Y. A comparison of laparoscopic radical hysterectomy and pelvic lymphadenectomy and laparotomy in the treatment of Ib-IIa cervical cancer. Gynecol Oncol. 2007;105:176-180.
Park DA, Yun JE, Kim SW, Lee SH. Surgical and clinical safety and effectiveness of robot-assisted laparoscopic hysterectomy compared to conventional laparoscopy and laparotomy for cervical cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2017;43:994-1002.
Bodur S, Dede M, Fidan U, Firatligil BF, Ulubay M, Ozturk M, Yenen MC. Arm reduced robotic-assisted laparoscopic hysterectomy with transvaginal cuff closure. Wideochir Inne Tech Maloinwazyjne. 2017;12(3):271-276. https://doi.org/10.5114/wiitm.2017.68772
Vizza E, Chiofalo B, Cutillo G, Mancini E, Baiocco E, Zampa A, Bufalo A, Corrado G. Robotic single site radical hysterectomy plus pelvic lymphadenectomy in gynecological cancers. J Gynecol Oncol. 2018;29(1):e2. https://doi.org/10.3802/jgo.2018.29.e2
Pellegrino A, Damiani GR, Loverro M, Pirovano C, Fachechi G, Corso S, Trojano G Comparison of Robotic and laparoscopic Radical type-B and C hysterectomy for cervical cancer: Long term-outcomes. Acta Biomed. 2017;88(3):289-296.
Nie JC, Yan AQ, Liu XS. Robotic-Assisted Radical Hysterectomy Results in Better Surgical Outcomes Compared With the Traditional Laparoscopic Radical Hysterectomy for the Treatment of Cervical Cancer. Int J Gynecol Cancer. 2017;27(9):1990-1999. https://doi.org/10.1097/IGC.0000000000001101
Khatkov IE, Ponomareva YuN, Loginova EA, Ulyanova AV, Ivanova LB. Robot-assisted laparoscopy in the treatment of gynecological oncological diseases. Endoscopicheskaya khirurgiya. 2020;26(2):50-57. (In Russ.). https://doi.org/10.17116/endoskop20202602150
Liu H, Lu D, Wang L, Shi G, Song H, Clarke J. Robotic surgery for benign gynecological disease. Cochrane Database Syst Rev. 2012;2:CD008978.
Corrado G, Chiantera V, Fanfani F, Cutillo G, Lucidi A, Mancini E, Gallotta V, Baiocco E, Monterossi G, Perri MT, Zampa A, Pasciuto T, Scambia G. Robotic hysterectomy in severely obese patients with endometrial cancer: a multicenter study. J Minim Invasive Gynecol. 2016;23:94-100.
Herling SF, Møller AM, Palle C, Grynnerup A, Thomsen T. Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer. Dan Med J. 2017;64(3). pii: A5343.
Smorgick N. Robotic-assisted hysterectomy: patient selection and perspectives. Int J Womens Health. 2017;9:157-161. https://doi.org/10.2147/IJWH.S99993
Lenihan JP, Kovanda C, Seshadri-Kreaden U. What is the learning curve for robotic assisted gynecologic surgery? J Minim Invasive Gynecol. 2008;15:589-594.
El-Achi V, Weishaupt J, Carter J, Saidi S. Robotic versus laparoscopic hysterectomy in morbidly obese women for endometrial cancer. J Robot Surg. 2021;15(3):483-487. https://doi.org/10.1007/s11701-020-01133-z
McGovern PG, Leitao MM, Jr, Martino MA. Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease. Obstet Gynecol. 2014;123(4):885.
Prodromidou A, Spartalis E, Tsourouflis G, Dimitroulis D, Nikiteas N. Robotic versus laparoendoscopic single-site hysterectomy: a systematic review and meta-analysis. J Robot Surg. 2020;14(5):679-686. https://doi.org/10.1007/s11701-020-01042-1
Clair KH, Tewari KS. Robotic surgery for gynecologic cancers: indications, techniques and controversies. J Obstet Gynaecol Res. 2020;46(6):828-843. https://doi.org/10.1111/jog.14228
Deimling TA, Eldridge JL, Riley KA, Kunselman AR, Harkins GJ. Randomized controlled trial comparing operative times between standard and robot-assisted laparoscopic hysterectomy. Int J Gynaecol Obstet. 2017;136(1):64-69. https://doi.org/10.1002/ijgo.12001
Nezhat C, Lavie O, Lemyre M, Gemer O, Bhagan L, Nezhat C. Laparoscopic hysterectomy with and without a robot: Stanford experience. JSLS. 2009;13(2):125-128.
Brunes M, Johannesson U, Häbel H, Söderberg MW, Ek M. Effects of Obesity on Peri- and Postoperative Outcomes in Patients Undergoing Robotic versus Conventional Hysterectomy. J Minim Invasive Gynecol. 2021;28(2):228-236. https://doi.org/10.1016/j.jmig.2020.04.038
Cusimano MC, Simpson AN, Dossa F, Liani V, Kaur Y, Acuna SA, Robertson D, Satkunaratnam A, Bernardini MQ, Ferguson SE, Baxter NN. Laparoscopic and robotic hysterectomy in endometrial cancer patients with obesity: a systematic review and meta-analysis of conversions and complications. Am J Obstet Gynecol. 2019;221(5):410-428.e19. https://doi.org/10.1016/j.ajog.2019.05.004
Moon AS, Garofalo J, Koirala P, Vu MT, Chuang L. Robotic Surgery in Gynecology. Surg Clin North Am. 2020;100(2):445-460. https://doi.org/10.1016/j.suc.2019.12.007
Pasic RP, Rizzo JA, Fang H, Ross S, Moore M, Gunnarsson C. Comparing robot-assisted with conventional laparoscopic hysterectomy: impact on cost and clinical outcomes. J Minim Invasive Gynecol. 2010;17(6):730-738.
Marra AR, Puig-Asensio M, Edmond MB, Schweizer ML, Bender D. Infectious complications of laparoscopic and robotic hysterectomy: a systematic literature review and meta-analysis. Int J Gynecol Cancer. 2019;29(3):518-530. https://doi.org/10.1136/ijgc-2018-000098
Schreuder HWR, Verheijen RHM. Robotic surgery. BJOG. 2009;116:198-213.
Advincula AP. Surgical techniques: robot-assisted laparoscopic hysterectomy with the da Vinci surgical system. Int J Med Robot. 2006;2(4):305-311.
Orady M, Hrynewych A, Nawfal AK, Wegienka G. Comparison of robotic-assisted hysterectomy to other minimally invasive approaches. JSLS. 2012;16(4):542-548.
Paraiso MF, Ridgeway B, Park AJ, Jelovsek JE, Barber MD, Falcone T, et al. A randomized trial comparing conventional and robotically assisted total laparoscopic hysterectomy. Am J Obstet Gynecol. 2013;208(5):368.e1-368.e7.
Sarlos D, Kots L, Stevanovic N, von Felten S, Schär G. Robotic compared with conventional laparoscopic hysterectomy: a randomized controlled trial. Obstet Gynecol. 2012;120(3):604-611.
Takmaz Ö, Güngör M. Robotic versus laparoscopic hysterectomy; comparison of early surgical outcomes. J Turk Ger Gynecol Assoc. 2020;21(4):260-264. https://doi.org/10.4274/jtgga.galenos.2020.2019.0187
Lundin ES, Carlsson P, Wodlin NB, Nilsson L, Kjölhede P. Cost-effectiveness of robotic hysterectomy versus abdominal hysterectomy in early endometrial cancer. Int J Gynecol Cancer. 2020;30(11):1719-1725. https://doi.org/10.1136/ijgc-2020-001611

Close metadata