Introduction This study was aimed to compare the surgical and clinical outcomes between conventional robot nerve sparing radical hysterectomy (C-RRH) and total mesometrial resection method of robot radical hysterectomy (TMMR-RRH)

Description TMMR can be standardized for all patients with locally defined tumors and appears to reduce morbidity, improve outcome and can potentially eliminate the need for adjuvant chemotherapy.It removes the complete Müllerian compartment except its distal part to preserve a functional vaginal vault. The identification of developmentally deduced pelvic visceroparietal compartments serves as a template for the lymph node basins to be cleared¹.

Conclusion/Implications The propensity score matched cohot of 66 patients in each group showed the overall survival rate was 89% in the C-RRH and 95% in the TMMR- RRH group (p=0.728) (HR 0.77; 95% CI 0.18–3.27) and disease free survival rate was 83% in the C-RRH and 83% in the TMMR-RRH group (p=0.949). (HR 1.03; 95% CI 0.45–3.27) (106 vs 39 months median follow up). The recurrence pattern was significantly different in both group(p=0.034) and was not significantly median time to recurrence (11 vs 18 months, p=0.271). In univariable and multivariable analysis with OS, involvement of resection margin(p=0.000) were found as independent significant risk factors and in regard to DFS involvement of resection margin(p=0.000) and deep stromal invasion( HR 3.84: 95% CI, 1.20–12.26, p=0.023) was found as independent significant risk factors. The present study found that TMMR-RRH provides the benefits of higher number of retrieved LNs, shorter operation times, however more blood loss and no disease free and overall survival benefit.