Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer

Jeffrey M. Fowler, Leigh G. Seamon, David E. Cohn, Debra L. Richardson, Sue Valmadre, Matthew J. Carlson, Gary S. Phillips

Research output: Contribution to journalArticle

99 Scopus citations

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, respectively. The median body mass index was 34 kg/m (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.

Original languageEnglish (US)
Pages (from-to)1207-1213
Number of pages7
JournalObstetrics and gynecology
Volume112
Issue number6
DOIs
StatePublished - Dec 1 2008

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ASJC Scopus subject areas

  • Obstetrics and Gynecology

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