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Obstet Gynecol. 2008 Dec;112(6):1207-13. doi: 10.1097/AOG.0b013e31818e4416.

Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer.

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  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio 43210-1228, USA.

Abstract

OBJECTIVE:

To report the learning curve and outcomes after our first 105 patients underwent robotic hysterectomy and pelvic-aortic lymphadenectomy for the comprehensive staging of endometrial cancer.

METHODS:

We prospectively collected patient demographics, operative times, complications, pathologic results, and length of stay on all patients who underwent robotic hysterectomy pelvic-aortic lymphadenectomy for clinical stage I or occult stage II endometrial carcinoma.

RESULTS:

One hundred five patients at The Ohio State University between March 2006 and April 2008 underwent exploration with the intent of robotic hysterectomy pelvic-aortic lymphadenectomy. Ninety-two (87.6%) were completed robotically and 13 (12.4%) were converted. The probability of conversion was 15% (95% confidence interval [CI] 8.4-25.7), 24% (95% CI 12.4-39.9), 35% (95% CI 15.9-59.6), and 48% (95% CI 19.1-77.8) for a body mass index of 40, 45, 50, and 55 kg/m(2), respectively. The median body mass index was 34 kg/m(2) (range 19-58). In patients who underwent a robotic hysterectomy pelvic-aortic lymphadenectomy (n=79, 75%) or a robotic hysterectomy-pelvic lymphadenectomy (n=6, 5.7%), the average operating time from skin opening to closure was 242 minutes (+/-50 minutes). The median estimated blood loss was 99 mL (+/-83 mL). The median number of lymph nodes recovered was 29 (range 9-56), 21 (range 5-40) pelvic nodes and 9 (range 2-21) aortic nodes. The median length of stay was 1 night. After analysis of the data, we determined approximately 20 cases are needed to gain proficiency.

CONCLUSION:

Early experience demonstrates that robotic hysterectomy pelvic-aortic lymphadenectomy for endometrial cancer is feasible, with approximately 20 procedures needed to gain proficiency.

LEVEL OF EVIDENCE:

III.

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PMID:
19037027
[PubMed - indexed for MEDLINE]
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