Outcome of robot-assisted surgery for stage IA endometrial cancer compared to open and laparoscopic surgery: A retrospective study at a single institution

Abstract Background Few studies have compared the efficacy of robot-assisted, laparoscopic, and open surgeries for endometrial cancer. We aimed to compare the efficacy and safety of these three types of surgeries for early-stage endometrial cancer. Methods In all, 175 patients with endometrial cancer of preoperative stage IA who had undergone laparotomic (n = 80), laparoscopic (n = 40), or robot-assisted (n = 55) modified radical hysterectomy at our hospital from 2010 to 2022 were included; surgical outcomes, perioperative complications, and prognoses were compared. Total operative and console times for robot-assisted surgery between patients who did and did not undergo pelvic lymphadenectomy was assessed. Results The robot-assisted group had the shortest total operative time. The estimated blood loss was lower in the laparoscopic and robot-assisted groups than in the laparotomy group. In advanced postoperative stage IA cases, there were no differences in progression-free and overall survival among the three groups. In the robot-assisted group, the operative time decreased with increasing number of operations; the learning curve was reached after 10 cases each of patients with and without pelvic lymphadenectomy. The frequency of perioperative complications of Clavien–Dindo classification Grade 1 or higher was the lowest in the robot-assisted group (p = 0.02). There were no complications of Clavien–Dindo classification Grade 2 or higher in the robot-assisted group. Conclusion Robot-assisted surgery for stage IA endometrial cancer, a minimally invasive procedure, has reduced operative times and complications compared with laparoscopic and open surgeries.