Radical hysterectomy has been a mainstay in the management of early-stage cervical cancer. With the advent of laparoscopy, and subsequently robotic surgery, more radical hysterectomies are now performed in a minimally invasive fashion. Minimally invasive radical hysterectomies entail greater complexity compared to simple hysterectomies. However, the robotic platform (the da Vinci Si® or Xi®; Intuitive Surgical, Sunnyvale, CA) offers improved visualization, dexterity, and better ergonomics for the surgeon. The robotic platform has some significant advantages compared with conventional laparoscopy. The instruments used in laparoscopy lack flexibility, and the surgeon must operate while standing and looking at a two-dimensional monitor. In the robotic system, the surgeon may remain seated; visualization is provided by a high-definition, three-dimensional camera; and wristed instruments are operated by movement of the surgeon’s hands through use of the EndoWrist® instrument, which affords extraordinary dexterity. In addition, three robotic arms may be used simultaneously. For the practiced clinician, utilization of the robot is advantageous in both simple and complex cases. This chapter will address the data supporting the use of the robotic platform for radical hysterectomy. We will also describe the procedure in a step-by-step fashion.
KeywordsRadical hysterectomy Robotic-assisted Minimally invasive Cervical cancer Endometrial cancer
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