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Laparoscopic and robotic techniques for radical hysterectomy in patients with early-stage cervical cancer
Pedro T Ramirez1, Pamela T Soliman, Kathleen M Schmeler
1Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77230-1439, USA. peramire@mdanderson.org
Objectives:
The goal of this review is to summarize the latest literature on the subject of laparoscopic and robotic approaches for radical hysterectomy in patients with early-stage cervical cancer.
Methods:
We analyzed the published literature in search of all articles addressing surgical techniques, intraoperative and perioperative outcomes in patient undergoing radical hysterectomy by the minimally invasive approach.
Results:
Recurrence and overall survival rates in patients with early-stage cervical cancer are equivalent in patients who undergo laparoscopic radical hysterectomy and those who undergo surgery performed by laparotomy. There is growing evidence highlighting the benefits of robotic surgery in management of gynecologic malignancies. The advantages of the robotic system include three-dimensional vision, tremor reduction, seven degrees of intra-abdominal articulation, and motion scaling. Recent studies comparing radical hysterectomy performed through the open, laparoscopic, or robotics approach showed that there were no significant differences in intra- or postoperative complications among the three groups and no conversion in the robotic or laparoscopic groups.
Conclusions:
Total laparoscopic radical hysterectomy is a feasible and safe procedure that is associated with fewer intraoperative and postoperative complications than abdominal radical hysterectomy. We await results from additional series of radical hysterectomy performed by robotic surgery.