Objective The aim of this study was to evaluate the feasibility of robotic radical hysterectomy (RRH) in patients with early stage cervical cancer.

Methods This retrospective study was carried out using data for 166 patients with T1b1-2/2a1, N0 cervical cancer who underwent radical hysterectomy at Hokkaido Cancer Center from January 2010 to April 2018. Study outcomes including operation time, estimated blood loss (EBL), number of lymph nodes harvested, hospital stay, surgical morbidity, recurrence, and survival were compared between open radical hysterectomy (O group, n=134) and RRH (R group, n=32).

Results There was no difference in age, body mass index, stage, histology, lymph node metastasis, and tumor diameter between the two group. RRH was significantly associated with longer operation time (268 min vs. 415 min, P < 00001), less EBL (492 cc vs. 30cc, P < 00001), shorter hospital stay (24 days vs. 10 days, P < 00001), and fewer number of lymph nodes harvested (42 vs. 18, P < 00001). RRH was marginally associated with fewer number of severe neurogenic bladder (49% vs, 31%, P = 0078). No severe neurogenic bladder was observed in the last eleven cases of RRH. At the time of this report, with a median follow-up of 22 months, only one patient recurred at her vaginal stump.

Conclusion If RRH was strictly applied to cases of T1b1-2/2a1, N0 cervical cancer, it could be feasible in early stage cervical cancer. In addition, RRH might decrease occurrence of severe neurogenic bladder compared to open radical hysterectomy.