Introduction/Background Robot-assisted surgery is considered an appropriate staging method for early stages of endometrial cancer. Available data evaluating the frequency of conversion of robot-assisted surgery to open surgery are limited. Similarly, the spectrum of causes leading to conversion is not defined.

Methodology None.

Results We present a cohort of 513 patients operated for early stage endometrial cancer between years 2009 and 2023 at our department. Patients with a mean age of 65 years (range from 29 to 90 years) and a mean BMI of 32.5 kg/m2 (range from 15.0 to 67.4 kg/m2) underwent a robot-assisted total laparoscopic hysterectomy, a bilateral adnexectomy and a lymph node staging procedure in accordance with current existing recommendations. The average procedure time was 250 minutes with an average blood loss of 118 ml. There were 7 conversions of robot-assisted laparoscopy to an open surgery in the patient cohort which is 1.4% of all. The average age of these patients was 68 years with an average BMI of 42,3 kg/m2. The average procedure time of the converted surgeries was 242 minutes and the average blood loss was 914 ml with majority developing during the open surgery. The most common cause of conversion was an iatrogenic injury: bleeding (from inferior vena cava, external iliac vein, abdominal wall) and a lesion of colon. Other causes were unexpected findings in the abdominal cavity (extensive tumour mass of the peritoneal cavity and intestine, massive adnextumour and severe adhesive process of the pelvis).

Conclusion Robot-assisted laparoscopic surgery is the gold standard for surgical staging of endometrial cancer. In our cohort of 513 patients, the conversion rate to laparotomy was 1.4%. The main causes were severe perioperative bleeding, unexpected perioperative findings, and lesions of the abdominal organs. The mean age of the patients in both groups was comparable, however the mean BMI was significantly different.

Disclosures None.