Robotic Surgery May Be Effective For Endometrial Cancer Staging


NEW ORLEANS — Robotic-assisted laparoscopy appears to be a safe and effective, minimally invasive alternative to traditional laparotomy for treating and staging endometrial cancer, according to a small retrospective study from one institution.

Dr. John P. Judd of the Ochsner Medical Center in New Orleans and his colleagues compared patients who had robotic-assisted laparoscopic hysterectomy (RALH) with staging to those who had traditional laparotomy with staging.

The laparoscopic approach has many benefits, but it also means a limited range of motion, a significant learning curve, and the ability to see in two dimensions only, said Dr. Judd, who presented his results at the annual meeting of the Society of Gynecologic Surgeons. Robotic surgery offers three-dimensional views, enhanced knot tying and suturing, and the potential for a shorter learning curve.

In the Ochsner study, there were 14 patients in the robotic group and 50 in the traditional laparotomy group. They underwent exploratory laparotomy from July 2005 to February 2008. Patients in the robotic group had significantly less blood loss than those undergoing the traditional exploratory method—148 mL vs. 300 mL. And the total operating room time also was significantly less for the robotic procedure, at 192 minutes, compared with 314 minutes.

There was a shorter total procedure time, and the average postoperative stay was only 1.8 days for the robotic groups, compared with 3.5 days for the traditional approach.

Although robotic surgery conferred the same or better benefits than traditional laparotomy, it was significantly more expensive. The total charge for robotic surgery was $40,298, compared with $27,320 for traditional surgery, he said.

Dr. Judd concluded that the benefits outweighed the costs of the robotic surgery. However, he noted, prospective trials with more patients are needed to confirm the benefits.

Dr. Judd reported no disclosures.

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