[Gynecological cancer surgery: Is robotic surgery an advantage over conventional laparoscopy?]

Minimally invasive surgery now plays a central role in the management of gynecologic cancers, particularly endometrial and cervical cancers. Among these approaches, robot-assisted surgery has progressively developed due to its potential technical advantages, including improved ergonomics, three-dimensional visualization, and greater precision of surgical maneuvers. Despite the increasing adoption of this technology, its true role compared with conventional laparoscopy remains debated, particularly following concerns raised regarding the oncologic safety of minimally invasive surgery in early-stage cervical cancer. This narrative review analyzes the currently available evidence comparing robot-assisted surgery with conventional laparoscopy in endometrial and cervical cancers. Priority is given to studies with a high level of evidence, particularly randomized controlled trials, while also discussing the methodological limitations of the existing literature, which is characterized by heterogeneity in the studied populations, biases related to historical cohorts, and the major impact of the learning curve. Through the evaluation of perioperative, functional, and oncologic outcomes, this review provides a critical synthesis of the current literature and discusses the main challenges associated with the integration of robot-assisted surgery in gynecologic oncology. Particular attention is paid to the influence of surgical expertise, healthcare organization, and adherence to oncologic principles on the observed outcomes. Ongoing prospective trials are expected to provide additional data to better define the role of robot-assisted surgery in gynecologic oncology.