Robotic Surgery in Endometrial Cancer
- 20 Downloads
Abstract
Purpose of Review
The number of minimal invasive gynecological oncological operations performed especially for endometrial cancer is increasing rapidly parallel with the increase in robotic systems in hospitals. This paper focuses on evaluating the studies comparing robotic surgery with laparoscopic and open surgery in patients with endometrial cancer in light of current literature.
Recent Findings
When the current literature is examined, it is seen that the results of robotic surgery have similar results to laparoscopy such as length of hospital stay, postoperative pain, recovery in a short time, and less blood vessels, and they are disadvantageous in terms of cost compared with laparoscopy. When compared with laparotomy, it is emphasized that there is no difference in terms of intraoperative oncologic surgery results and it is a method that can be chosen as a minimally invasive surgery option especially in obese patients because of its ergonomics.
Summary
Although there is no randomized controlled study comparing the results of laparoscopic and open surgery with robotic surgery, retrospective data suggests that perioperative morbidity in robotic surgery is less and improves in terms of intraoperative surgical outcomes. As with benign gynecological procedures, randomized controlled trials are needed to identify patients who may benefit from robotic surgery and to better define clinical outcomes. It should be noted that randomized controlled trials comparing surgical and robotic-assisted surgery with laparoscopy are lacking and most of them are derived from retrospective data.
Keywords
Robotic surgery Endometrial cancer Minimal invasive surgeryNotes
Compliance with Ethical Standards
Conflict of Interest
Ahmet Göçmen and Fatih Şanlıkan declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7.CrossRefGoogle Scholar
- 2.Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366:491–505.CrossRefGoogle Scholar
- 3.Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Int J Gynecol Cancer. 2016;26:2–30.CrossRefGoogle Scholar
- 4.Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, et al. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008;199:360–9.PubMedGoogle Scholar
- 5.Childers JM, Brzechffa PR, Hatch KD, Surwit EA. Laparoscopically assisted surgical staging (LASS) of endometrial cancer. Gynecol Oncol. 1993;51:33–8.CrossRefGoogle Scholar
- 6.Magrina JF. Outcomes of laparoscopic treatment for endometrial cancer. Curr Opin Obstet Gynecol. 2005;17:343–6.CrossRefGoogle Scholar
- 7.Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009;27(32):5331–6.CrossRefGoogle Scholar
- 8.Stylopoulos N, Rattner D. Robotics and ergonomics. Surg Clin North Am. 2003;83:1321–37.CrossRefGoogle Scholar
- 9.Oehler MK. Robot-assisted surgery in gynaecology. Aust N Z J Obstet Gynaecol. 2009;49:124–9.CrossRefGoogle Scholar
- 10.Lauterbach R, Matanes E, Lowenstein L. Review of robotic surgery in gynecology-the future is here. Rambam Maimonides Med J 2017; 28;8(2).CrossRefGoogle Scholar
- 11.Sfakianos GP, Frederick PJ, Kendrick JE, Straughn JM, Kilgore LC, Huh WK. Robotic surgery in gynecologic oncology fellowship programs in the USA: a survey of fellows and fellowship directors. Int J Med Robotics. 2010;6:405–12.CrossRefGoogle Scholar
- 12.Committee opinion no. 628: robotic surgery in gynecology. Obstet Gynecol 2015 ;125(3):760–7.Google Scholar
- 13.Von Gruenigen VE, Showalter AL, Gil KM, Frasure HE, Hopkins MP, Jenison EL. Complementary and alternative medicine use in the Amish. Complement Ther Med. 2001;9:232–3.CrossRefGoogle Scholar
- 14.Gehrig PA, Cantrell LA, Shafer A, Abaid LN, Mendivil A, Boggess JF. What is the optimal minimally invasive surgical procedure for endometrial cancer staging in the obese and morbidly obese woman? Gynecol Oncol. 2008;111(1):41–5.CrossRefGoogle Scholar
- 15.Hoekstra AV, Jairam-Thodla A, Rademaker A, Singh DK, Buttin BM, Lurain JR, et al. The impact of robotics on practice management of endometrial cancer: transitioning from traditional surgery. Int J Med Robot. 2009;5(4):392–7.CrossRefGoogle Scholar
- 16.Veljovich DS, Paley PJ, Drescher CW, Everett EN, Shah C, Peters WA. Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging. Am J Obstet Gynecol. 2008;198:1–10.CrossRefGoogle Scholar
- 17.DeNardis SA, Holloway RW, Bigsby GE, Pikaart DP, Ahmad S, Finkler NJ. Robotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer. Gynecol Oncol. 2008;111:412–7.CrossRefGoogle Scholar
- 18.Paley PJ, Veljovich DS, Shah CA, Everett EN, Bondurant AE, Drescher CW, Peters WA 3rd. Surgical outcomes in gynecologic oncology in the era of robotics: analysis of first 1000 cases. Am J Obstet Gynecol 2011;204(6):551.e1–9.CrossRefGoogle Scholar
- 19.Park DA, Lee DH, Kim SW, Lee SH. Comparative safety and effectiveness of robot-assisted laparoscopic hysterectomy versus conventional laparoscopy and laparotomy for endometrial cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2016;42:1303–14.CrossRefGoogle Scholar
- 20.Chiou HY, Chiu LH, Chen CH, Yen YK, Chang CW, Liu WM. Comparing robotic surgery with laparoscopy and laparotomy for endometrial cancer management: a cohort study. Int J Surg. 2015;13:17–22.CrossRefGoogle Scholar
- 21.Coronado PJ, Herraiz MA, Magrina JF, Fasero M, Vidart JA. Comparison of perioperative outcomes and cost of robotic-assisted laparoscopy, laparoscopy and laparotomy for endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2012;165:289–94.CrossRefGoogle Scholar
- 22.Chen SH, Li ZA, Huang R, Xue HQ. Robot-assisted versus conventional laparoscopic surgery for endometrial cancer staging: a meta-analysis. Taiwan J Obstet Gynecol. 2016;55:488–94.CrossRefGoogle Scholar
- 23.Gaia G, Holloway RW, Santoro L, Ahmad S, Di Silverio E, Spinillo A. Robotic-assisted hysterectomy for endometrial cancer compared with traditional laparoscopic and laparotomy approaches: a systematic review. Obstet Gynecol. 2010;116(6):1422–31.CrossRefGoogle Scholar
- 24.Lauterbach R, Matanes E, Lowenstein L. Review of robotic surgery in gynecology-the future is here. Rambam Maimonides Med J. 2017;28:8(2).Google Scholar
- 25.Barrie A, Freeman AH, Lyon L, Garcia C, Conell C, Abbott LH, et al. Classification of postoperative complications in robotic-assisted compared with laparoscopic hysterectomy for endometrial cancer. J Minim Invasive Gynecol. 2016;23:1181–8.CrossRefGoogle Scholar
- 26.Mäenpää MM, Nieminen K, Tomás EI, Laurila M, Luukkaala TH, Maenpää JU. Robotic-assisted vs traditional laparoscopic surgery for endometrial cancer: a randomized controlled trial. Am J Obstet Gynecol. 2016;215:588.e1–7.CrossRefGoogle Scholar
- 27.El Sahwi KS, Hooper C, De Leon MC, et al. Comparison between 155 cases of robotic vs. 150 cases of open surgical staging for endometrial cancer. Gynecol Oncol. 2012;124:260–4.CrossRefGoogle Scholar
- 28.Hinshaw SJ, Gunnderson S, Eastwood D, Bradley WH. Endometrial carcinoma: the perioperative and long-term outcomes of robotic surgery in the morbidly obese. J Surg Oncol. 2016;114:884–7.CrossRefGoogle Scholar
- 29.Gala RB, Margulies R, Steinberg A, Murphy M, Lukban J, Jeppson P, et al. Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy. J Minim Invasive Gynecol. 2014;21(3):353–61.CrossRefGoogle Scholar
- 30.•Ind T, Laios A, Hacking M, Nobbenhuis M. A comparison of operative outcomes between standard and robotic laparoscopic surgery for endometrial cancer: a systematic review and meta-analysis. Int J Med Robot 2017 ;13(4). This systematic review and meta-analysis demonstrates that the current evidence is in favor of robotic-assisted laparoscopic surgery for endometrial cancer over standard laparoscopy for clinic outcomes but costs are greater than laparoscopy. Google Scholar
- 31.Xie W, Cao D, Yang J, Shen K, Zhao L. Robot-assisted surgery versus conventional laparoscopic surgery for endometrial cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol. 2016;142:2173–83.CrossRefGoogle Scholar
- 32.••Cusimano MC, Simpson AN, Dossa F, Liani V, Kaur Y, et al. 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 May 10. This is the most recent systematic review and meta-analysis about laparoscopic and robotic hysterectomy in endometrial cancer patients with obesity. It includes information on the surgical outcomes of 10,800 endometrial cancer patients with obesity underwent robotic and laparoscopic surgery comparing conversion to laparotomy and complications. Google Scholar
- 33.Corrado G, Mereu L, Bogliolo S, Cela V, Freschi L, Carlin R, et al. Robotic single site staging in endometrial cancer: a multi-institution study. Eur J Surg Oncol. 2016;42:1506–11.CrossRefGoogle Scholar
- 34.Matanes E, Lauterbach R, Boulus S, Amit A, Lowenstein L. Robotic laparoendoscopic single-site surgery in gynecology: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2018;231:1–7.CrossRefGoogle Scholar