Our website uses cookies to improve your on-site experience. By using the website, cookies are being used as described in our Policy Document
Warning: To log in you will need to enable cookies and reload the page (Policy Document)
My ePortfolio Register   
 

Abstract | Full HTML Article | PDF ecancer 1 55 / https://doi.org/10.3332/ecancer.2007.55

Case Report

Robotic modified radical hysterectomy with pelvic lymphadenectomy

A Maggioni, L Bocciolone, M Peiretti, F Landoni, V Zanagnolo, L Minig, G Roviglione and N Colombo

Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy


Abstract

Radical hysterectomy, the complete removal of a woman's uterus, is usually performed via an abdominal incision that requires a 3–5 day hospital stay and a 6–8 week recovery period. Now, in a handful of hospitals around the world, new robotic technology allows doctors to perform this procedure through small incisions that require a recovery time of only one night in the hospital and a significantly shorter recovery period at home. Watch such a procedure being carried out at the European Institute of Oncology.


Objective

To report the feasibility and safety of robotic modified radical hysterectomy and bilateral pelvic lymphadenectomy, using the four-arm da Vinci robot system, in a patient with early-stage cervical carcinoma.

Methods

The patient is a 37-year-old woman P0G0, who was diagnosed with a severe cervical dysplasia on a pap smear during a regular follow-up check-up visit. She underwent a biopsy that revealed a grade three invasive cervical squamous carcinoma, and she was referred to our institute. The computerized tomography of the abdomen and pelvis was negative for metastatic disease, and MRI of the pelvis revealed a cervical lesion of 16 x 12 mm. She was therefore offered a radical hysterectomy, using the da Vinci robotic set. She signed an informed consent form, and the risks and benefits of open surgery, versus a minimally invasive procedure, were discussed.

Click the play button to begin:

Results

The overall operative time was two hours and 20 minutes, with only two minutes for docking of the robotic arms. Estimated blood loss was <50 cc. There were no intra-operative or post-operative complications. Patient removed Foley catheter on post-operative day three, and she went home the same day with intermittent self-catheterization. Pathological findings revealed a squamous cell carcinoma G3 with a depth of stromal invasion of 6 mm and horizontal extension of 12 mm. No lymph vascular spaces involvements were noted. Bilateral parametria and vaginal margins were free of the disease. Twenty-six negative pelvic lymph nodes were removed.


Conclusion

Modified radical hysterectomy with bilateral pelvic lymphadenectomy using the four-armed da Vinci Robot seems to be a safe and feasible procedure. Surgeons can clearly benefit from better dexterity precision and visualization with the three-dimensional imaging than conventional laparoscopy. Limitations such as the absence of tactile feedback and high costs will need to be addressed from further controlled studies.

 

Categories:

Ovary & gynaecology

Loading Article Metrics ... Please wait

Related articles

Short Communication: COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?

Abstract | Full Article | PDF Published: 30 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1023

Review: Associations between immune-suppressive and stimulating drugs and novel COVID-19—a systematic review of current evidence

Abstract | Full Article | PDF Published: 27 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1022

Clinical Study: Prospective study to assess the survival outcomes of planned irradiation of ipsilateral subventricular and periventricular zones in glioblastoma

Abstract | Full Article | PDF Published: 26 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1021

Research: Impact of HER2 status in resected gastric or gastroesophageal junction adenocarcinoma in a Western population

Abstract | Full Article | PDF | Español Published: 24 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1020

Clinical Study: Sequential chemotherapy followed by radical thoracic radiotherapy (50 Gy in 25 fractions) in limited stage small cell lung cancer

Abstract | Full Article | PDF Published: 09 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1019



Founding partners

European Cancer Organisation European Institute of Oncology

Founding Charities

Foundazione Umberto Veronesi Fondazione IEO Swiss Bridge

Published by

ecancer Global Foundation