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 Citations (Scopus)

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 2008

Fingerprint

Robotics
Endometrial Neoplasms
Lymph Node Excision
Hysterectomy
Confidence Intervals
Length of Stay
Body Mass Index
Learning Curve
Operative Time
Lymph Nodes
Demography
Skin

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. / Fowler, Jeffrey M.; Seamon, Leigh G.; Cohn, David E.; Richardson, Debra L.; Valmadre, Sue; Carlson, Matthew J.; Phillips, Gary S.

In: Obstetrics and Gynecology, Vol. 112, No. 6, 12.2008, p. 1207-1213.

Research output: Contribution to journalArticle

Fowler, Jeffrey M. ; Seamon, Leigh G. ; Cohn, David E. ; Richardson, Debra L. ; Valmadre, Sue ; Carlson, Matthew J. ; Phillips, Gary S. / Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. In: Obstetrics and Gynecology. 2008 ; Vol. 112, No. 6. pp. 1207-1213.
@article{be65ea42ad3249f2959970f6be18f1db,
title = "Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer",
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.",
author = "Fowler, {Jeffrey M.} and Seamon, {Leigh G.} and Cohn, {David E.} and Richardson, {Debra L.} and Sue Valmadre and Carlson, {Matthew J.} and Phillips, {Gary S.}",
year = "2008",
month = "12",
doi = "10.1097/AOG.0b013e31818e4416",
language = "English (US)",
volume = "112",
pages = "1207--1213",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer

AU - Fowler, Jeffrey M.

AU - Seamon, Leigh G.

AU - Cohn, David E.

AU - Richardson, Debra L.

AU - Valmadre, Sue

AU - Carlson, Matthew J.

AU - Phillips, Gary S.

PY - 2008/12

Y1 - 2008/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=58849121009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58849121009&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e31818e4416

DO - 10.1097/AOG.0b013e31818e4416

M3 - Article

C2 - 19037027

AN - SCOPUS:58849121009

VL - 112

SP - 1207

EP - 1213

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 6

ER -