title: Robot-assisted staging using three robotic arms for endometrial cancer: comparison to laparoscopy and laparotomy at a single institution.
abstract: OBJECTIVE
  To demonstrate the feasibility of robot-assisted staging surgery using three arms in patients with endometrial cancer.
  
  
  METHODS
  One hundred nine patients with clinical stage I endometrial cancer who underwent staging surgery at Yonsei University Health System were enrolled from May 2006 to January 2009. Patient demographics and operative outcomes were prospectively collected.
  
  
  RESULTS
  Robotic surgery using three arms was performed in 28 patients, laparoscopy in 25, and laparotomy in 56. There were no differences among the three groups in terms of patient demographics. The number of harvested pelvic lymph nodes was lower in the laparoscopy group than in the laparotomy group (18.36 +/- 7.25 vs. 24.39 +/- 10.08, respectively, P = 0.025), but there was no difference between the robot and laparotomy groups. The number of resected para-aortic lymph nodes and operative time did not differ among the three groups. The average hospital stay was longer for the laparotomy group than the robot and laparoscopy groups (10.78 days vs. 7.92 days vs. 7.67 days, respectively, P < 0.001). Operative complications and transfusions developed more frequently in the laparotomy group than in the robot and laparoscopy groups (25.0% vs. 7.1% vs. 8.0%, respectively, P = 0.049; 42.9% vs. 14.3% vs. 16.0%, respectively, P = 0.006).
  
  
  CONCLUSIONS
  Robot-assisted surgery using three arms is a feasible method for surgical staging in patients with clinical stage I endometrial cancer.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Wook
authors.initials: YW
authors.lastname: Jung
authors.forename: Dae Woo
authors.initials: DW
authors.lastname: Lee
authors.forename: Sang Wun
authors.initials: SW
authors.lastname: Kim
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging; D012371:Robotics / Q000295:instrumentation*