Abstract

Background: Surgical staging is the standard of care for the treatment of endometrial cancer. In April of 2005, the da Vinci® robot was approved by the FDA for use in gynecologic procedures. We performed a retrospective chart review in order to compare the short and long term outcomes of robotic-assisted laparoscopic hysterectomy (RAHL) with total abdominal hysterectomy (TAH). Methods: Endometrial cancer patients who had hysterectomies by either RAHL (n=203) or TAH (n=78) were compared. Data including demographic and pathologic characteristics, operative time, lymph node yield, hospital length-of-stay, estimated blood loss, complications, adjuvant therapy, and recurrence rates was collected from electronic medical records and analyzed. Results: Demographic and pathologic characteristics were similar between the two groups. Operative time (min) was significantly higher in the RAHL group (TAH=79.2±18.1; RAHL=166.8±44.4; p=<.0001). Lymph node yield was greater in the robotic cohort (TAH=18±10; 21± 11.7; p=.0464). Hospital length of stay (days) was significantly longer in the TAH cohort (3.2±1.1; 1.2±1.1; p=<.0001). Estimated blood loss (ml) was significantly greater in the TAH cohort (224±98.5; 91±70.9; p=<.0001). The overall percentage of patients who experienced greater than one complication was significantly higher in the TAH cohort (TAH=61.6%; RAHL=38.4%; p=.0036). The rates of cuff dehiscence were notably higher in the RAHL cohort, though not enough to reach significance. There was no significant difference between the recurrence rates of the two cohorts (p=.4124). Conclusions: Robotic hysterectomy is a safe and effective alternative to open hysterectomy that represents advantages in short term recovery with comparable long term results.