Comprehensive Staging of Uterine Carcinosarcoma Using a Multiquadrant Robotic Platform

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Extensive para-aortic lymphadenectomies and infragastric omentectomies are challenging in uterine cancer staging.
• Current laparoscopic and robotic approaches may not fully encompass these extensive procedures.

Purpose of the Study:

• To demonstrate the feasibility of multiquadrant staging for uterine carcinosarcoma using a latest-generation robotic platform.
• To showcase a robotic technique for comprehensive staging, including extensive lymphadenectomy and omentectomy.

Main Methods:

• A step-by-step explanation of the multiquadrant robotic staging technique is provided with visual aids.
• The procedure involves robotic-assisted laparoscopic total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and infragastric omentectomy.

Main Results:

• The technique was demonstrated on a 67-year-old patient with uterine carcinosarcoma.
• Total operative time was 280 minutes with an estimated blood loss of 50 mL.
• Pathology confirmed stage IA uterine carcinosarcoma with 27 para-aortic and 20 pelvic lymph nodes removed.

Conclusions:

• The multiquadrant robotic platform facilitates extensive para-aortic lymphadenectomies and infragastric omentectomies.
• This integrated approach allows surgeons to complete comprehensive staging without switching to laparoscopic surgery.