title: The impact of robotics on practice management of endometrial cancer: transitioning from traditional surgery.
abstract: BACKGROUND
  Evaluation of the impact of a new robotic surgery programme on perioperative outcomes for endometrial cancer
  
  
  METHODS
  A prospective database of all patients undergoing staging for endometrial cancer during July 2007-July 2008 was collected and analysed. Demographic data and perioperative outcomes were compared between cases performed via laparotomy, laparoscopy and robotics.
  
  
  RESULTS
  Sixty-five patients underwent staging during the time of data collection (LAP-26, LSC-7, ROB-32). No difference in surgical volume in the year before vs. after robotics was identified. Median operative time for robotics and laparotomy was significantly less than for laparoscopy (p = 0.023). There was no significant difference in lymph node yields between the three groups (p = 0.92). Robotics was associated with significantly less blood loss (p < 0.0001). Complication rates were significantly lower in the robotic group compared to the laparotomy group (p = 0.05). Median hospital stay was 1 day for the minimally invasive groups. Total number of perioperative inpatient days decreased from 331 to 150 in one year. Practice management of endometrial cancer transitioned from a predominantly open approach (5.6% LSC) to robotics (11% LSC, 49% ROB) within 12 months.
  
  
  CONCLUSIONS
  Robotic surgery dramatically altered our management of endometrial cancer and was associated with a significant improvement in several perioperative outcomes when compared to laparotomy and laparoscopy.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 250 East Superior Street, Chicago, IL 60611, USA.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Hoekstra
authors.forename: Arati
authors.initials: A
authors.lastname: Jairam-Thodla
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: Diljeet K
authors.initials: DK
authors.lastname: Singh
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Buttin
authors.forename: John R
authors.initials: JR
authors.lastname: Lurain
authors.forename: Julian C
authors.initials: JC
authors.lastname: Schink
authors.forename: M Patrick
authors.initials: MP
authors.lastname: Lowe
mesh_terms: D002641:Chicago / Q000453:epidemiology; D055356:Endometrial Ablation Techniques / Q000706:statistics & numerical data*; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012371:Robotics / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D016526:Workload / Q000706:statistics & numerical data*