Robot-assisted surgery in treatment of patients with uterine cancer

Background. Uterine cancer is one of the most common oncological diseases in women. Among women between the ages of 60 and 74 years, it’s the 2nd most common cancer. This underlies the importance of studies aimed at improvement of treatment of this disease. Implementation of robotic technologies is seen as a promising method for improvement of surgical results of uterine cancer treatment in accordance with all oncological principles.

Aim. To analyze clinical results of robot-assisted uterine extirpation in patients with stage I endometrioid uterine cancer.

Materials and methods. Between 2023 and 2025, at the Division of Oncological Surgery of Pelvic Organs of the A.S. Loginov Moscow Clinical Research Center of the Moscow Healthcare Department, 450 robot-assisted uterine extirpations due to stage Ia–Ib endometrioid uterine cancer were performed. Mean age of the patients was 60.2 [34–86] years. Mean BMI was 37.5 [18.5–56.4] kg/m2, in 20 % this parameter was higher than 40 kg/m2, maximum value was 56.4 kg/m2. Practically all patients had history of somatic diseases.

Results. Standard extirpation of the uterus with appendages was performed in 369 (82 %) cases, extirpation of the uterus with fallopian tubes in 18 (4 %) cases (in patients younger than 45 years), extirpation of the uterus and pelvic lymph node dissection in 63 (14 %) cases. Total operative time was 99.9 [55–210] min, duration of the Xi da Vinci robotic system docking varied between 5 and 10 min. Mean blood loss volume was 95 [50–150] mL. In 1 patient with burdened oncological and surgical history, conversion was performed due to extensive adhesive process in the abdominal cavity. No significant complications per the Сlavien–Dindo classification were reported.

Conclusion. The results demonstrate safety of robot-assisted surgery per the main parameters of the perioperative period: operative time, blood loss volume, risk of blood transfusion, conversion and complication rates, hospitalization time. Minimal invasiveness, high accuracy and ergonomics in combination with oncological radicalness make robot-assisted interventions a method of choice for surgical treatment of stage I endometrioid uterine cancer if technical equipment and experienced surgical team are available.

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