Robot-assisted surgeries in the treatment of malignant uterine tumors

摘要

Objective. To evaluate the feasibility of performing robot-assisted surgeries for all relevant nosologies in minimally invasive oncogynecology Material and methods. The medical records of 68 patients operated on in the oncogynecological department of the City Clinical Hospital named after S.P. Botkin from 2020 to 2023 using robotic technologies for endometrial cancer IA—II stage and cervical cancer in situ — IA1 stage were retrospectively analyzed. Over 3 years, 52 (76.5%) type A uterine extirpations, 12 (17.6%) operations with pelvic lymphadenectomy, and 4 (5.9%) uterine extirpations with pelvic and para-aortic lumbar lymphadenectomy were performed. Results. The duration of robot-assisted hysterectomy ranged from 70 to 200 minutes, with an average operation time of 117 minutes. The duration of hysterectomy with pelvic lymphadenectomy was 90—190 minutes, with an average time of 170.4 minutes. When performing lumbar para-aortic lymphadenectomy, the duration of the operation increased to 300—370 minutes. Blood loss did not exceed 30 ml in the group where only the uterus was removed, while in the other two groups, the average intraoperative blood loss was at the level of 34.3 and 50.4 ml, respectively. During pelvic lymphadenectomy, the average number of removed nodes was 12.8, and lumbar localization — 10.6. Conclusion. Robot-assisted surgery in oncogynecology is feasible, safe, and can be fully utilized for all necessary volumes of operations relevant to minimally invasive surgery according to modern requirements. Considering that robotic technologies will continue to evolve, this direction is expected to yield the most interesting technological breakthroughs.