title: Rate of port-site metastasis is uncommon in patients undergoing robotic surgery for gynecological malignancies.
abstract: OBJECTIVE
  To describe the rate of port-site metastasis in patients who underwent robotic surgery for suspected gynecological malignancy.
  
  
  METHODS
  Using a prospective database, we identified all patients who underwent robotic surgery performed by the Gynecologic Oncology service at 1 institution between December 2006 and March 2010. Records of patients with confirmed malignancy were reviewed for clinicopathological data and information about port-site metastasis.
  
  
  RESULTS
  One hundred eighty-one patients met the inclusion criteria. The median age was 55.4 years (range, 19-82 years), and the median body mass index was 29.6 kg/m² (range, 17.9-70.7 kg/m²). Port-site metastases were detected in 2 patients (1.1%) at 3 weeks (patient 1) and 11 months (patient 2) after surgery. Patient 1 underwent surgery for an adnexal mass, and pathological examination revealed gallbladder adenocarcinoma metastatic to the ovary. She had a recurrence in the right lateral abdominal wall robotic trocar site with concurrent metastases in the gallbladder fossa and liver. Patient 2 was diagnosed with adenocarcinoma of unclear (cervical vs endometrial) origin. Imaging showed metastases in pelvic and para-aortic lymph nodes. She underwent laparoscopy and was found intraoperatively to have gross disease on the right ovary. The patient underwent right salpingo-oophorectomy and chemoradiation. She had residual disease in the cervix and subsequently underwent robotic hysterectomy and left salpingo-oophorectomy. Pathological examination revealed endometrial cancer. She had a recurrence at the transumbilical trocar site concurrent with retroperitoneal lymphadenopathy and carcinomatosis. There were no cases of isolated port-site metastasis.
  
  
  CONCLUSIONS
  The rate of port-site metastasis after robotic surgery in women with gynecological cancer is low and similar to the rate for laparoscopic procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Bih T
authors.initials: BT
authors.lastname: Ndofor
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D012371:Robotics / Q000379:methods; D055815:Young Adult