Introduction/Background The aim of this study was to investigate the role of robotic surgery compared with laparoscopic surgery in frail overweight or obese patients affected by endometrial carcinoma.

Methodology From April 2019 and December 2023 overweight or obese women who underwent surgery for intermediate and high-risk endometrial cancer were considered for the study. Consecutive patients were treated by robotic surgery (Group A). Surgical results were compared to those of a historical group of patients (Group B) with the same characteristics treated by conventional laparoscopy. A propensity-score matching algorithm (1:1) was used to allocate patients into the study groups.

Results Sixty-one consecutive intermediate and high-risk endometrial cancer treated undergoing robotic surgery were considered. Charts of 361 ’high intermediate patients’ treated by conventional laparoscopy were retrieved. Overall, 61 patients undergoing robotic surgery were matched with 62 patients undergoing laparoscopic surgery. No difference in terms of mean age (61.87 ± 12.46 vs 64.18 ± 11.00), body mass index (BMI) (29.72 ± 8.04 vs 28.7 ± 4.5), rate of diabetes (14.6% vs 8%), or hypertension (50% vs 48%) were found.

Mean age adjusted Charlson comorbidity index (ACCI) was respectively 3.89 ± 2.11 vs 3.54 ± 1.71 in robotic and laparoscopic cohort. Robotic surgery was associated with lower conversion rate (1.6% vs 16.1%, p=0.008) and lower overall grade of complications rate at 30 days (1.6% vs 17.7%, p=0.004). No difference in terms of severe complications were reported between groups.

Conclusion These data seem to support the hypothesis that robotic surgery is feasible and safe in frail, overweight or obese patients. However, further research is needed to confirm this finding.

Disclosures None.