OBJECTIVE: The aim of this study was to compare and determine the feasibility, surgical outcomes,
learning curves of robotic radical
hysterectomy with
lymph node dissection (RRHND) to conventional laparoscopic radical
hysterectomy with
lymph node dissection (LRHND) performed by a single surgeon, in
patients with
cervical cancer .
METHODS: Between April 2009 and March 2013, 22
patients underwent LRHND and 19
patients underwent RRHND. Variables such as age,
body mass index , International
Federation of
Gynecology and
Obstetrics stage, histological results, number of dissected
lymph nodes ,
operative time , estimated
blood loss, days of
hospitalization and
complications were reviewed.
Learning curves of operation
time was obtained using cumulative sum (CUSUM)
method .
RESULTS: Both groups showed
similar patient and
tumor characteristics. In surgical outcome
analysis , RRHND (51.8±10.4 minutes) showed longer preparing
time than LRHND (42.5±14.1 minutes). In the LRHND group, 8
patients experienced
postoperative complications (5 void difficulty, 1 postoperative
bleeding , 1 right
basal ganglia infarction , 1
fever ). On the other
hand , in the RRHND group, 4
patients experienced a
postoperative complication (2
bleeding , 1
peritonitis , 1 dehiscence of
trocar site). Using CUSUM
method , the
learning curves were obtained by plotting the cumulative sequential differences between each data point and the average operation
time , and showed two distinct phases in both type of operations.
CONCLUSION: RRHND would be appropriate surgical approach in
patients with
cervical cancer with favorable outcome of less voiding difficulty. A minimum of 13 cases of robotic radical
hysterectomies are required to achieve surgical improvement in the
treatment of
cervical cancer .