Objectives Robotic hysterectomy and sentinel lymph node biopsy (SLNB) using Indocyanine green is an effective and safe alternative treatment for patients with endometrial cancer.

Methods A single-institutional retrospective study was performed including all patients with intermediate-risk endometrial cancer who underwent robotic hysterectomy plus SLNB using ICG between January 2020 and April 2021. Surgical outcomes of these patients regarding lymphoedema and lymphocele formation were compared in a retrospective manner with outcomes of endometrial cancer patient that underwent abdominal hysterectomy and complete pelvic lymph node dissection.

Results In total from January 2020 until April 2021, 15 patients were surgically treated for intermediate endometrial cancer with robotic hysterectomy and SLNB using ICG. Their outcomes were compared with those who underwent abdominal hysterectomy plus pelvic lymph node dissection for endometrial cancer (30 patients). Regarding oncological outcome, 8 out of 15 patients of robotic group were treated for endometrioid endometrial cancer stage IB low grade without LVSI, while the rest of them had endometrioid endometrial cancer stage IA high grade. None of the included patients had metastases to the sentinel lymph node. Regarding the complications, none of the robotic group patients suffered from lymphoedema or lymphocele formation, while in abdominal group 1 out of 30 suffered from lymphoedema and 5 from lymphocele formation.

Conclusions Although our small experience, according to our results robotic hysterectomy in combination with SLNB is a feasible treatment that can be used in treatment of patients with intermediate endometrial cancer with same or even better long term results regarding lymphatic drainage.