Introduction Sentinel lymph node sampling (SLN) for early stage cervical cancer can reduce complications compared to systematic lymphadenectomy and improve detection rate in less common chains. The use of in-built robotic indocynanine green (ICG) techniques has potential to further reduce morbidity.

Methods This series examines women with Stage 1AII to 1BI cervical cancer who underwent lymph node dissection using ICG in a single tertiary referral centre between May 2015 and Jan 2020. SLN was performed using the Da Vinci Xi robot, with the pelvic sidewalls, pre-sacral spaces, and lower para-aortic chains screened intra-operatively. Ultra-staging was performed on samples.

Results A total of 116 women had SLN dissection. Of these, 45 (38.8%) had this performed at the time of hysterectomy, 61 (52.6%) at the time of cone biopsy or trachelectomy, and 10 (8.6%) at an interval. In the women who had full lymphadenectomy the lymphedema rate was 18.2% compared to 0.0% in the SLN group. The bilateral detection rate was 96.6% (112 women) and the most common sites of SLNs the external iliac and obturator chains, and the most common site of positive nodes the obturator chain. There were positive lymph nodes in 8.6% of women. Of the 88 women who had complete lymphadenectomy, 6 had positive nodes and all had positive SLN giving a sensitivity and negative predictive value of 100%.

Conclusion/Implications Robotic sentinel lymph node dissection compared to systematic pelvic lymphadenectomy in early stage cervical cancer is an accurate method with low morbidity.