Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer

Ga Won Yim, Kyung Jin Eoh, Young Shin Chung, Sang Wun Kim, Sunghoon Kim, Eun Ji Nam, Jung Yun Lee, Young Tae Kim

Research output: Contribution to journalArticle

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Abstract

Study Objective: To investigate and compare surgical outcomes of the 3 versus 4 robotic arm approaches for robotic surgery in patients with cervical cancer. Design: A retrospective analysis of prospectively collected data (Canadian Task Force classification II-2). Setting: An academic tertiary hospital. Patients: A total of 142 patients with stage 1A1 to IIB cervical carcinoma who underwent robotic surgery were included for analysis. The subjects were divided according to the surgical approach (i.e., the number of robotic arms), and the 2 groups were compared in terms of intraoperative data and postoperative outcomes. Interventions: Robotic radical hysterectomy (RRH) with lymphadenectomy using 3 robotic arms (n = 101) versus 4 robotic arms (n = 41). Measurements and Main Results: Perioperative surgical outcomes. The 3-arm robotic approach consisted of a camera arm, 2 robotic arms, and 1 conventional assistant port. An additional robotic arm was placed on the right side of the patient's abdomen for the 4-arm robotic approach. The mean age, body mass index, cell type, Fédération Internationale de Gynécologie et d'Obstétrique stage, and type of surgery were not significantly different between the 2 cohorts. The 3-arm approach showed favorable outcomes over the 4-arm approach in terms of postoperative pain at 6 and 24 hours (3.8 ± 1.8 vs 4.5 ± 1.7 and 2.8 ± 1.7 vs 3.4 ± 1.6, respectively; p =.033 and.049) and postoperative hemoglobin difference (1.8 ± 0.9 vs 2.6 ± 1.3 and 1.9 ± 1.1 vs 2.4 ± 0.9 on days 1 and 3, respectively; p =.002 and.004). The median length of postoperative hospital stay, total operative time, docking time, lymph node yield, and intraoperative and postoperative complication rates were comparable between the 2 cohorts. Conclusion: Surgical outcomes and complications rates of RRH for cervical cancer using the 4-arm approach were comparable with that of the 3-arm approach with decreased early postoperative pain in the 3-arm group. Cost-benefit analysis and the impact on surgical training are needed in the future.

Original languageEnglish
Pages (from-to)823-831
Number of pages9
JournalJournal of Minimally Invasive Gynecology
Volume25
Issue number5
DOIs
Publication statusPublished - 2018 Jul 1

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Robotics
Hysterectomy
Uterine Cervical Neoplasms
Arm
Postoperative Pain
Intraoperative Complications
Patient Rights
Advisory Committees
Operative Time
Lymph Node Excision
Tertiary Care Centers
Abdomen
Cost-Benefit Analysis
Length of Stay
Hemoglobins
Body Mass Index
Lymph Nodes
Carcinoma

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

Yim, Ga Won ; Eoh, Kyung Jin ; Chung, Young Shin ; Kim, Sang Wun ; Kim, Sunghoon ; Nam, Eun Ji ; Lee, Jung Yun ; Kim, Young Tae. / Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer. In: Journal of Minimally Invasive Gynecology. 2018 ; Vol. 25, No. 5. pp. 823-831.
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author = "Yim, {Ga Won} and Eoh, {Kyung Jin} and Chung, {Young Shin} and Kim, {Sang Wun} and Sunghoon Kim and Nam, {Eun Ji} and Lee, {Jung Yun} and Kim, {Young Tae}",
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Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer. / Yim, Ga Won; Eoh, Kyung Jin; Chung, Young Shin; Kim, Sang Wun; Kim, Sunghoon; Nam, Eun Ji; Lee, Jung Yun; Kim, Young Tae.

In: Journal of Minimally Invasive Gynecology, Vol. 25, No. 5, 01.07.2018, p. 823-831.

Research output: Contribution to journalArticle

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T1 - Perioperative Outcomes of 3-Arm Versus 4-Arm Robotic Radical Hysterectomy in Patients with Cervical Cancer

AU - Yim, Ga Won

AU - Eoh, Kyung Jin

AU - Chung, Young Shin

AU - Kim, Sang Wun

AU - Kim, Sunghoon

AU - Nam, Eun Ji

AU - Lee, Jung Yun

AU - Kim, Young Tae

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N2 - Study Objective: To investigate and compare surgical outcomes of the 3 versus 4 robotic arm approaches for robotic surgery in patients with cervical cancer. Design: A retrospective analysis of prospectively collected data (Canadian Task Force classification II-2). Setting: An academic tertiary hospital. Patients: A total of 142 patients with stage 1A1 to IIB cervical carcinoma who underwent robotic surgery were included for analysis. The subjects were divided according to the surgical approach (i.e., the number of robotic arms), and the 2 groups were compared in terms of intraoperative data and postoperative outcomes. Interventions: Robotic radical hysterectomy (RRH) with lymphadenectomy using 3 robotic arms (n = 101) versus 4 robotic arms (n = 41). Measurements and Main Results: Perioperative surgical outcomes. The 3-arm robotic approach consisted of a camera arm, 2 robotic arms, and 1 conventional assistant port. An additional robotic arm was placed on the right side of the patient's abdomen for the 4-arm robotic approach. The mean age, body mass index, cell type, Fédération Internationale de Gynécologie et d'Obstétrique stage, and type of surgery were not significantly different between the 2 cohorts. The 3-arm approach showed favorable outcomes over the 4-arm approach in terms of postoperative pain at 6 and 24 hours (3.8 ± 1.8 vs 4.5 ± 1.7 and 2.8 ± 1.7 vs 3.4 ± 1.6, respectively; p =.033 and.049) and postoperative hemoglobin difference (1.8 ± 0.9 vs 2.6 ± 1.3 and 1.9 ± 1.1 vs 2.4 ± 0.9 on days 1 and 3, respectively; p =.002 and.004). The median length of postoperative hospital stay, total operative time, docking time, lymph node yield, and intraoperative and postoperative complication rates were comparable between the 2 cohorts. Conclusion: Surgical outcomes and complications rates of RRH for cervical cancer using the 4-arm approach were comparable with that of the 3-arm approach with decreased early postoperative pain in the 3-arm group. Cost-benefit analysis and the impact on surgical training are needed in the future.

AB - Study Objective: To investigate and compare surgical outcomes of the 3 versus 4 robotic arm approaches for robotic surgery in patients with cervical cancer. Design: A retrospective analysis of prospectively collected data (Canadian Task Force classification II-2). Setting: An academic tertiary hospital. Patients: A total of 142 patients with stage 1A1 to IIB cervical carcinoma who underwent robotic surgery were included for analysis. The subjects were divided according to the surgical approach (i.e., the number of robotic arms), and the 2 groups were compared in terms of intraoperative data and postoperative outcomes. Interventions: Robotic radical hysterectomy (RRH) with lymphadenectomy using 3 robotic arms (n = 101) versus 4 robotic arms (n = 41). Measurements and Main Results: Perioperative surgical outcomes. The 3-arm robotic approach consisted of a camera arm, 2 robotic arms, and 1 conventional assistant port. An additional robotic arm was placed on the right side of the patient's abdomen for the 4-arm robotic approach. The mean age, body mass index, cell type, Fédération Internationale de Gynécologie et d'Obstétrique stage, and type of surgery were not significantly different between the 2 cohorts. The 3-arm approach showed favorable outcomes over the 4-arm approach in terms of postoperative pain at 6 and 24 hours (3.8 ± 1.8 vs 4.5 ± 1.7 and 2.8 ± 1.7 vs 3.4 ± 1.6, respectively; p =.033 and.049) and postoperative hemoglobin difference (1.8 ± 0.9 vs 2.6 ± 1.3 and 1.9 ± 1.1 vs 2.4 ± 0.9 on days 1 and 3, respectively; p =.002 and.004). The median length of postoperative hospital stay, total operative time, docking time, lymph node yield, and intraoperative and postoperative complication rates were comparable between the 2 cohorts. Conclusion: Surgical outcomes and complications rates of RRH for cervical cancer using the 4-arm approach were comparable with that of the 3-arm approach with decreased early postoperative pain in the 3-arm group. Cost-benefit analysis and the impact on surgical training are needed in the future.

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