Annals of Surgical Oncology

, Volume 20, Issue 8, pp 2759–2764 | Cite as

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

  • Enrico Vizza
  • Giacomo Corrado
  • Emanuela Mancini
  • Ermelinda Baiocco
  • Lodovico Patrizi
  • Luana Fabrizi
  • Luca Colantonio
  • Monica Cimino
  • Stefano Sindico
  • Ester Forastiere
Gynecologic Oncology

Abstract

Background

To evaluate the feasibility and the safety of robotic single-site hysterectomy (RSSH) in low risk early endometrial cancer.

Methods

Patients with clinical low risk early endometrial cancer were enrolled onto a prospective cohort trial. All surgical procedures were performed through a single 2–2.5 cm 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 8.5 mm 3D HD endoscope, a 5/10 mm accessory port, and an insufflation adaptor.

Results

Between December 2011 and June 2012, a total of 17 patients were included in our pilot study. The median age of the patients was 64 years (range, 42–84 years), and median body mass index was 26.6 kg/m2 (range, 18–52 kg/m2). 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 8 min (range, 5–14 min), 48 min (range, 45–51 min), and 90 min (range, 70–147 min), respectively. The median blood loss was 75 mL (range, 50–150 mL). No laparoscopy/laparotomy conversion was registered. The median time to discharge was 2 days (range, 1–3 days). Neither intraoperative nor postoperative complications occurred. At a median of 7.5 months’ follow-up, all patients were disease-free.

Conclusions

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.

Notes

Acknowledgment

The authors wish to thank Dr. Elena Cimatti, Dr. Marco Calcavento, and the nursing staff for their assistance during the robotic surgery.

Disclosure

The authors declare no conflict of interest.

References

  1. 1.
    Ghezzi F, Cromi A, Uccella S, et al. Laparoscopic versus open surgery for endometrial cancer: a minimum 3-year follow-up study. Ann Surg Oncol. 2010;17:271–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Lowe MP, Johnson PR, Kamelle S, et al. A multiinstitutional experience with robotic-assisted hysterectomy with staging for endometrial cancer. Obstet Gynecol. 2009;114:236–43.PubMedCrossRefGoogle Scholar
  3. 3.
    Fader AN, Escobar PF. Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: technique and initial report. Gynecol Oncol. 2009;114:157–61.PubMedCrossRefGoogle Scholar
  4. 4.
    Fanfani F, Rossitto C, Gagliardi ML, et al. Total laparoendoscopic single site surgery (LESS) hysterectomy in low risk early endometrial cancer: a pilot study. Surg Endosc. 2012;26:41–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Kroh M, El-Hayek K, Rosenblatt S, et al. First human surgery with a novel singleport robotic system: cholecystectomy using the da Vinci single-site platform. Surg Endosc. 2011;25:3566–73.PubMedCrossRefGoogle Scholar
  6. 6.
    FIGO Committee on Gynecologic Oncology. Staging classifications and clinical practice guidelines of gynaecologic cancers. Int J Gynecol Obstet. 2000;70:207–312.CrossRefGoogle Scholar
  7. 7.
    Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303.PubMedCrossRefGoogle Scholar
  8. 8.
    Konstantinidis KM, Hirides P, Hirides S, et al. Cholecystectomy using a novel Single-Site® robotic platform: early experience from 45 consecutive cases. Surg Endosc. 2012;26:2687–94.Google Scholar
  9. 9.
    White MA, Autorino R, Spana G, et al. Robotic laparoendoscopic single site urological surgery: analysis of 50 consecutive cases. J Urol. 2012;187:1696–701.PubMedCrossRefGoogle Scholar
  10. 10.
    Escobar PF, Kebria M, Falcone T. Evaluation of a novel single-port robotic platform in the cadaver model for the performance of various procedures in gynecologic oncology. Gynecol Oncol. 2011;120:380–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Fagotti A, Gagliardi ML, Fanfani F, et al. Perioperative outcomes of total laparoendoscopic single-site hysterectomy versus total robotic hysterectomy in endometrial cancer patients: a multicentre study. Gynecol Oncol. 2012;125:552–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Escobar PF, Fader AN, Paraiso MF, et al. Robotic-assisted laparoendoscopic single-site surgery in gynecology: initial report and technique. J Minim Invasive Gynecol. 2009;16:589–91.PubMedCrossRefGoogle Scholar
  13. 13.
    Barnett JC, Judd JP, Wu JM, Scales CD Jr, Myers ER, Havrilesky LJ. Cost comparison among robotic, laparoscopic, and open hysterectomy for endometrial cancer. Obstet Gynecol. 2010;116:685–93.PubMedCrossRefGoogle Scholar
  14. 14.
    Lau S, Vaknin Z, Ramana-Kumar AV, Halliday D, Franco EL, Gotlieb WH. Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery. Obstet Gynecol. 2012;119:717–24.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Enrico Vizza
    • 1
  • Giacomo Corrado
    • 1
  • Emanuela Mancini
    • 1
  • Ermelinda Baiocco
    • 1
  • Lodovico Patrizi
    • 2
  • Luana Fabrizi
    • 3
  • Luca Colantonio
    • 3
  • Monica Cimino
    • 1
  • Stefano Sindico
    • 1
  • Ester Forastiere
    • 3
  1. 1.Gynecologic Oncologic Unit, Department of Oncological Surgery“Regina Elena” National Cancer InstituteRomeItaly
  2. 2.Section of Gynecology, Academic Department of Biomedicine and Prevention and ClinicalTor Vergata UniversityRomeItaly
  3. 3.Anesthesia Unit, Department of Intensive Care, Pain Therapy and Palliative Care“Regina Elena” National Cancer InstituteRomeItaly

Personalised recommendations