Skip to main content
SpringerLink
Log in

Initial experience with the da Vinci SP robot-assisted surgical staging of endometrial cancer: a retrospective comparison with conventional laparotomy

  • Research
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

To compare the perioperative outcomes of surgical staging performed using conventional laparotomy (LT) or the da Vinci SP robotic system (SP) in patients with endometrial cancer. We retrospectively analyzed 180 patients with stage I–III endometrial cancer who underwent surgical staging using LT (n = 126) or SP (n = 54) at the Yonsei Cancer Center between November 2018 and December 2022. Propensity score matching (PSM) was performed to mitigate potential confounding biases. Fifty-one pairs of patients were matched by PSM. SP required longer total operation time than LT (221 vs. 142 min in SP vs. LT, respectively, p < 0.001). However, estimated blood loss and postoperative hemoglobin change were lower in SP than in LT (30 vs. 100 mL, p < 0.001; 0.6 vs. 1.6 g/dL, p < 0.001 for SP vs. LT respectively). Furthermore, postoperative minor complications (13.7% in SP vs. 33.3% in LT, p = 0.02), perioperative transfusion rate (0% in SP vs. 11.8% in LT, p = 0.03), and postoperative hospital stay (2 days for SP vs. 8 days for LT, p < 0.001) were lower in SP than in LT. Although the patient-controlled analgesia administration rate was lower in SP (13.8% in SP vs. 100% in LT, p < 0.001), the median postoperative pain score at 6, 12, and 24 h after surgery was lower in SP than in LT (2 vs. 3, p = 0.002; 2 vs. 3, p = 0.005; 2 vs. 3, p = 0.001 for SP vs. LT, respectively). Although SP required longer total operation time, it demonstrated several advantages over LT in endometrial cancer staging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Owing to privacy and ethical concerns, neither the data nor its source can be made available.

References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660

    Article  PubMed  Google Scholar 

  2. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E (2016) Endometrial cancer. Lancet 387(10023):1094–1108. https://doi.org/10.1016/S0140-6736(15)00130-0

    Article  PubMed  Google Scholar 

  3. Koskas M, Amant F, Mirza MR, Creutzberg CL (2021) Cancer of the corpus uteri: 2021 update. Int J Gynaecol Obstet 155(Suppl 1):45–60. https://doi.org/10.1002/ijgo.13866

    Article  PubMed  PubMed Central  Google Scholar 

  4. Berek JS, Matias-Guiu X, Creutzberg C, Fotopoulou C, Gaffney D, Kehoe S et al (2023) FIGO staging of endometrial cancer: 2023. Int J Gynaecol Obstet. https://doi.org/10.1002/ijgo.14923

    Article  PubMed  Google Scholar 

  5. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS et al (2009) Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 27(32):5331–5336. https://doi.org/10.1200/jco.2009.22.3248

    Article  PubMed  PubMed Central  Google Scholar 

  6. Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R et al (2010) Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol 11(8):772–780. https://doi.org/10.1016/s1470-2045(10)70145-5

    Article  PubMed  Google Scholar 

  7. Kornblith AB, Huang HQ, Walker JL, Spirtos NM, Rotmensch J, Cella D (2009) Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a gynecologic oncology group study. J Clin Oncol 27(32):5337–5342. https://doi.org/10.1200/jco.2009.22.3529

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tantitamit T, Lee CL (2019) Application of sentinel lymph node technique to transvaginal natural orifices transluminal endoscopic surgery in endometrial cancer. J Minim Invasive Gynecol 26(5):949–953. https://doi.org/10.1016/j.jmig.2018.10.001

    Article  PubMed  Google Scholar 

  9. Lee CL, Liu HM, Khan S, Lee PS, Huang KG, Yen CF (2022) Vaginal natural orifice transvaginal endoscopic surgery (vNOTES) surgical staging for endometrial carcinoma: the feasibility of an innovative approach. Taiwan J Obstet Gynecol 61(2):345–352. https://doi.org/10.1016/j.tjog.2022.02.026

    Article  PubMed  Google Scholar 

  10. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. https://doi.org/10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  11. Eoh KJ, Lee DW, Lee JH, Nam EJ, Kim SW, Kim YT (2021) Comparative survival outcome of robot-assisted staging surgery using three robotic arms versus open surgery for endometrial cancer. Yonsei Med J 62(1):68–74. https://doi.org/10.3349/ymj.2021.62.1.68

    Article  PubMed  Google Scholar 

  12. Kwak YH, Lee H, Seon K, Lee YJ, Lee YJ, Kim SW (2022) Da Vinci SP single-port robotic surgery in gynecologic tumors: single surgeon’s initial experience with 100 cases. Yonsei Med J 63(2):179–186. https://doi.org/10.3349/ymj.2022.63.2.179

    Article  PubMed  PubMed Central  Google Scholar 

  13. Eoh KJ, Lee YJ, Kim H-S, Lee J-Y, Nam EJ, Kim S et al (2018) Two-step sentinel lymph node mapping strategy in endometrial cancer staging using fluorescent imaging: a novel sentinel lymph node tracer injection procedure. Surg Oncol 27(3):514–519. https://doi.org/10.1016/j.suronc.2018.07.001

    Article  PubMed  Google Scholar 

  14. Janda M, Gebski V, Davies LC, Forder P, Brand A, Hogg R et al (2017) Effect of total laparoscopic hysterectomy vs total abdominal hysterectomy on disease-free survival among women with stage I endometrial cancer: a randomized clinical trial. JAMA 317(12):1224–1233. https://doi.org/10.1001/jama.2017.2068

    Article  PubMed  Google Scholar 

  15. Backes FJ, ElNaggar AC, Farrell MR, Brudie LA, Ahmad S, Salani R et al (2016) Perioperative outcomes for laparotomy compared to robotic surgical staging of endometrial cancer in the elderly: a retrospective cohort. Int J Gynecol Cancer 26(9):1

    Article  Google Scholar 

  16. Coronado PJ, Herraiz MA, Magrina JF, Fasero M, Vidart JA (2012) Comparison of perioperative outcomes and cost of robotic-assisted laparoscopy, laparoscopy and laparotomy for endometrial cancer. Eur J Obstet Gynecol Reprod Biol 165(2):289–294. https://doi.org/10.1016/j.ejogrb.2012.07.006

    Article  PubMed  Google Scholar 

  17. Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN et al (2008) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol 199(4):360.e361-360.e369. https://doi.org/10.1016/j.ajog.2008.08.012

    Article  Google Scholar 

  18. Ran L, Jin J, Xu Y, Bu Y, Song F (2014) Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: A meta-analysis. PLoS ONE 9(9):e108361. https://doi.org/10.1371/journal.pone.0108361

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Galaal K, Donkers H, Bryant A, Lopes AD (2018) Laparoscopy versus laparotomy for the management of early stage endometrial cancer. Cochrane Database Syst Rev 10. https://doi.org/10.1002/14651858.CD006655.pub3

  20. Perrone E, Capasso I, Pasciuto T, Gioè A, Gueli Alletti S, Restaino S et al (2021) Laparoscopic vs robotic-assisted laparoscopy in endometrial cancer staging: large retrospective single-institution study. J Gynecol Oncol 32(3):45. https://doi.org/10.3802/jgo.2021.32.e45

    Article  CAS  Google Scholar 

  21. Fu H, Zhang J, Zhao S, He N (2023) Survival outcomes of robotic-assisted laparoscopy versus conventional laparoscopy and laparotomy for endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol 174:55–67. https://doi.org/10.1016/j.ygyno.2023.04.026

    Article  PubMed  Google Scholar 

  22. Argenta PA, Mattson J, Rivard CL, Luther E, Schefter A, Vogel RI (2022) Robot-assisted versus laparoscopic minimally invasive surgery for the treatment of stage I endometrial cancer. Gynecol Oncol 165(2):347–352. https://doi.org/10.1016/j.ygyno.2022.03.007

    Article  PubMed  PubMed Central  Google Scholar 

  23. Eoh KJ, Kim Y-N, Nam EJ, Kim SW, Kim YT (2023) Clinical relevance of uterine manipulation on oncologic outcome in robot-assisted versus open surgery in the management of endometrial cancer. J Clin Med 12(5):1950

  24. Ito H, Moritake T, Isaka K (2022) Does the use of a uterine manipulator in robotic surgery for early-stage endometrial cancer affect oncological outcomes? Int J Med Robot Comput Assist Surg 18(6):e2443

    Article  Google Scholar 

  25. Chen SH, Li ZA, Huang R, Xue HQ (2016) Robot-assisted versus conventional laparoscopic surgery for endometrial cancer staging: a meta-analysis. Taiwan J Obstet Gynecol 55(4):488–494. https://doi.org/10.1016/j.tjog.2016.01.003

    Article  PubMed  Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea

    Ki Eun Seon, Yong Jae Lee, Jung-Yun Lee, Eun Ji Nam, Sunghoon Kim, Young Tae Kim & Sang Wun Kim

Authors
  1. Ki Eun Seon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong Jae Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jung-Yun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eun Ji Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sunghoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Young Tae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sang Wun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: SWK. Data collection: SWK, KES, YJL, JYL, EJN, SK and YTK. Analysis and interpretation: SWK and KES. Statistical analysis: SWK and KES. Manuscript writing: KES. Manuscript editing: SWK. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Sang Wun Kim.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest related to this study.

Ethical approval

The Institutional Review Board of Yonsei University Health System, Severance Hospital, granted approval for this study (Protocol number: 4-2023-0136, dated March 31, 2023), and informed consent was waived.

Consent to participate

Informed consent was waived as patient information was anonymized, and the study does not include any data that may identify the patients.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 179 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seon, K.E., Lee, Y.J., Lee, JY. et al. Initial experience with the da Vinci SP robot-assisted surgical staging of endometrial cancer: a retrospective comparison with conventional laparotomy. J Robotic Surg 17, 2889–2898 (2023). https://doi.org/10.1007/s11701-023-01730-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-023-01730-8

Keywords

Search

Navigation