Robotic Single-site Hysterectomy in Low Risk Endometrial Cancer: A Pilot Study

To evaluate the feasibility and the safety of robotic single-site hysterectomy (RSSH) in low risk early endometrial cancer.

Patients with clinical low risk early endometrial cancer were enrolled onto a prospective cohort trial. All surgical procedures were performed through a single 2–2.5 cm umbilical incision, with a multichannel system consisting of a five-lumen port providing access for two single-site instruments (da Vinci Si Surgical System, Intuitive Surgical, Sunnyvale, CA), the 8.5 mm 3D HD endoscope, a 5/10 mm accessory port, and an insufflation adaptor.

Between December 2011 and June 2012, a total of 17 patients were included in our pilot study. The median age of the patients was 64 years (range, 42–84 years), and median body mass index was 26.6 kg/m² (range, 18–52 kg/m²). One patient was excluded from the study as a result of pelvic metastasis during inspection of abdominal cavity, and another patient was converted to vaginal surgery as a result of problems of hypercapnia. The median docking time, console time, and total operative time was 8 min (range, 5–14 min), 48 min (range, 45–51 min), and 90 min (range, 70–147 min), respectively. The median blood loss was 75 mL (range, 50–150 mL). No laparoscopy/laparotomy conversion was registered. The median time to discharge was 2 days (range, 1–3 days). Neither intraoperative nor postoperative complications occurred. At a median of 7.5 months’ follow-up, all patients were disease-free.

RSSH is technically feasible in patients affected by low risk early endometrial cancer. Additional studies with gynecologic oncologic cases should be performed to explore the possible benefits of RSSH.