Introduction/Background Minimally invasive staging surgery is considered as a new standard surgical modality in early stage ovarian cancer. Especially, Robot-assisted surgery is an advanced form to overcome the limitations of conventional laparoscopic surgery, providing steady three-dimensional vision and articulated instruments without tremor and a shorter learning curve. This video aims to demonstrate the robot assisted laparoscopic staging surgery in early stage of ovarian cancer.

Methodology A 54 years old woman presented with an ovarian cyst suspected to fibroma or granulosa cell tumor on CT scan and elevated CA 125 level. And she was diagnosed with ovarian malignancy, serous carcinoma, after diagnostic laparoscopic bilateral salpingo-oophorectomy. PET-CT scan showed no enlarged lymph node nor abnormal finding in peritoneal cavity. To determine FIGO stage of ovarian cancer, we performed Robot assisted staging surgery including total laparoscopic hysterectomy, omentectomy, bilateral pelvic lymph node dissection and para-aortic lymph node dissection (level 4). We used the da Vinci Xi multi-port surgical platform (Intuitive Surgical, Inc., CA, USA) and three robotic instruments: fenestrated bipolar forceps, monopolar curved scissors and prograsp forceps (Intuitive Surgical).

Results The final diagnosis was FIGO stage IA of high grade ovarian serous carcinoma (grade 3). The total operation took 375 minutes and the patient was discharged in five days after surgery without postoperative complications.

Conclusion Robot assisted laparoscopic staging surgery is feasible and safe with early ovarian cancer. Additionally, prospective randomized clinical trials will be able to evaluate the clinical benefits of robot-assisted surgery.