title: Surgical outcomes in gynecologic oncology in the era of robotics: analysis of first 1000 cases.
abstract: OBJECTIVE
  We sought to examine outcomes in an expanding robotic surgery (RS) program.
  
  
  METHODS
  In all, 1000 women underwent RS from May 2006 through December 2009. We analyzed patient characteristics and outcomes. A total of 377 women undergoing RS for endometrial cancer staging (ECS) were compared with the historical data of 131 undergoing open ECS.
  
  
  RESULTS
  For the entire RS cohort of 1000, the conversion rate was 2.9%. Body mass index increased over 3 time intervals: T1 = 26.2, T2 = 29.5, T3 = 30.1 (T1:T2, P = .01; T1:T3, P = .0001; T2:T3, P = .037). Increasing body mass index was not associated with increased major complications: T1 = 8.7%, T2 = 4.3%, T3 = 5.7%. In the ECS cohort, as compared with open ECS, women undergoing RS had lower blood loss (46.9 vs 197.6 mL, P < .0001), shorter hospitalization (1.4 vs 5.3 days, P < .0001), fewer major complications (6.4% vs 20.6%, P < .0001), with higher lymph node counts (15.5 vs 13.1, P = .007).
  
  
  CONCLUSIONS
  RS is associated with favorable morbidity and conversion rates in an unselected cohort. Compared to laparotomy, robotic ECS results in improved outcomes.
authors.affiliation: Pacific Gynecology Specialists Inc, Swedish Medical Center, Seattle, WA 98104, USA. ppaley@pacificgyn.com
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Paley
authors.forename: Dan S
authors.initials: DS
authors.lastname: Veljovich
authors.forename: Chirag A
authors.initials: CA
authors.lastname: Shah
authors.forename: Elise N
authors.initials: EN
authors.lastname: Everett
authors.forename: Amy E
authors.initials: AE
authors.lastname: Bondurant
authors.forename: Charles W
authors.initials: CW
authors.lastname: Drescher
authors.forename: William A
authors.initials: WA
authors.lastname: Peters
mesh_terms: D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012371:Robotics; D016896:Treatment Outcome