Introduction/Background Minimally invasive surgery (MIS) is the preferred route for women with endometrial cancer. Although robotic surgery is not yet NHS standard, it was introduced at Royal London Hospital in November 2017. The effect of introducing robotic surgery (RAH) on the length of stay (LOS) and laparotomy rates in women undergoing surgery for endometrial cancer was assessed.
Methodology Electronic patient records were reviewed for all women undergoing surgery for endometrial cancer in 2016 and 2018 and analysed using Microsoft Excel and IBM SPSS.
Results A total of 95 and 103 women (same mean age of 66) had surgery in 2016 and 2018 respectively.
In 2016, after examination under anaesthetic (EUA), 53 (56%) proceeded to TAH and 42(44%) to TLH. 2 (0.02%) were converted from TLH to TAH. The median BMI, estimated blood loss (EBL) and LOS for the TAH group were 32 kg/m2, 350 ml and 6 days respectively whereas for TLH were 30 kg/m2, 100 ml and 2 days.
In 2018, 37 (35%) had TAH and 67 (65%) MIS hysterectomy. In the MIS group, 21 (31%) had TLH and 45 (69%) RAH. 7 (11%) and 1(1%) were converted from RAH to TAH and vaginal hysterectomy respectively. Of these 8, 7 were draped but not docked. The median BMI, EBL and LOS for the TAH group were 28.6 kg/m2, 400 ml and 5 days, for TLH were 28 kg/m2, 100 ml and 1 day and for RAH were 39.3 kg/m2, 100 ml and 2 days respectively.
The overall LOS has fallen from 5 days in 2016 to 3 in 2018 (p<0.01). The overall rate of TAH has fallen from 53/95 to 36/103 (p<0.01).
Reasons for conversion included anaesthetic, adhesions, intraoperative complications and uterine perforation.
Conclusion RAH has enabled complex operating in high-risk cases while significantly reducing LOS and laparotomy rates.
Disclosure Nothing to disclose.
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