Robotic-assisted surgery in the management of endometrial cancer

Advanced laparoscopic procedures for hysterectomy and staging lymphadenectomy were not widely adopted for management of endometrial cancer despite nearly 20 years of improvements in laparoscopic technology. Many surgeons have recently embraced da Vinci robotic-assisted laparoscopy in preference to traditional laparoscopy because of its technological advantages of wristed instrumentation, high-definition 3-D optics, ergonomics and autonomy of camera control; the majority of women with endometrial cancer in the USA now undergo robotic-assisted surgery. The purpose of this article is to review the robotic surgical techniques for hysterectomy, pelvic and aortic lymphadenectomy procedures, and the current comparative literature discussing perioperative outcomes. Additionally, literature that discusses challenges managing obese patients and robotic surgical costs are reviewed. Future multi-institutional, prospective registration studies comparing perioperative outcomes, complications, pain, recovery time, cost and long-term clinical outcomes with open, laparoscopic and robotic procedures will be necessary to completely appreciate the impact of robotic-assisted technology.