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369 A detailed analysis of learning curve: robotic assisted type-i extrafascial pan hysterectomy with pelvic and high paraaortic lymphadenectomy for endometrial cancer– single institution study
  1. VK Ahuja1,
  2. S Somashekhar2,
  3. C Rohit Kumar2,
  4. K Ashwin2 and
  5. Y Ramya2
  1. 1Manipal Comphrensive Cancer Centre- Manipal Hospital- Bengaluru, Gynec-oncology, Bengaluru, India
  2. 2Manipal Comphrensive Cancer Centre- Manipal Hospital- Bengaluru, Surgical Oncology, Bengaluru, India


Objectives The present prospective non-randomized observational study was designed to analyze the proficiency and efficiency of robotic assisted type-1 extrafascial pan hysterectomy with pelvic and paraaortic lymphadenectomy in treatment of high-risk endometrial cancer patients.

Methods 131 consecutive proven high-risk patients with endometrial cancer underwent type-1 extra fascial pan hysterectomy with pelvic and high para-aortic lymphadenectomy using the daVinci® robotic surgical procedures at single quaternary care institution. Data was analyzed under five parameter, docking time, surgeons console time, total combined time taken and number of lymph nodes retrieved. The surgery team had same surgeon, same assistant doctor, same technician, and same nurse in all cases.

Results Target docking time of 7 minutes was achived at 29th case, however there were spikes in the docking time even after 100th case. Target surgeons console time of 180 minutes was achieved at 12th case and thereby consistently maintained 180 minutes or less. The direction of CUSUM line changes at 12th case and maintained the downward trend. Target number of pelvic lymph node 12 was achieved by 9th case. & of para-aortic lymph node 10 was achieved at 18th case. However, even after achieving the target, the variation was widely seen.

Conclusions In conclusion, the daVinci® robotics technology in our practice enabled us to offer minimal invasive surgery to endometrial cancer patients in a short time.The robotic-assisted procedures seems to offer a safe and useful alternative to conventional surgical techniques & would be a tool in armamentarium of gynec-oncologist.

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