title: The safety and feasibility of robotic-assisted lymph node staging in early-stage ovarian cancer.
abstract: OBJECTIVE
  The purpose of this study was to report on the safety and feasibility of robotic-assisted systematic lymph node staging in the management of early-stage ovarian cancer.
  
  
  METHODS
  We retrospectively reviewed the charts of presumed early-stage (International Federation of Gynecology and Obstetrics (FIGO) stages I and II) ovarian cancer patients who underwent robotic-assisted surgery that incorporated a systematic pelvic and para-aortic lymphadenectomy from January 2009 until December 2013. Patient demographics, operative characteristics, pathology, lymph node counts, surgical complications, and hospital stay were evaluated.
  
  
  RESULTS
  A total of 26 early-stage ovarian cancer patients were identified. The mean operating time was 2.90 hours, and the estimated blood loss was 63 mL; there were no intraoperative complications although 1 patient's surgery was significantly prolonged due to pelvic adhesions. The mean number of pelvic and para-aortic lymph nodes removed was 14.6 (2.3% incidence of pelvic lymph node metastases) and 5.8 (3.3% incidence of para-aortic lymph node metastases), respectively. The patients' mean duration of hospital stay was 18.4 hours, and 2 patients were readmitted for either a postoperative wound infection or vaginal dehiscence.
  
  
  CONCLUSIONS
  The results from this study suggest that robotic-assisted surgical staging in the management of presumed early-stage ovarian cancer is both feasible and associated with a minimal patient complication rate. We encountered a low incidence of lymph node metastases, and the readmission rate was favorable. Nevertheless, because the prevalence of lymph node metastases can approach 20% in select patients, physicians should consider a systematic lymph node resection to confer an optimal clinical assessment.
authors: *Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center; and †The Nancy Yeary Women's Cancer Research Foundation, Newport Beach, CA.
authors: John V
authors: JV
authors: Brown
authors: Alberto A
authors: AA
authors: Mendivil
authors: Lisa N
authors: LN
authors: Abaid
authors: Mark A
authors: MA
authors: Rettenmaier
authors: John P
authors: JP
authors: Micha
authors: Marie A
authors: MA
authors: Wabe
authors: Bram H
authors: BH
authors: Goldstein
mesh_terms: D001011:Aorta; D000077216:Carcinoma, Ovarian Epithelial; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging / Q000295:instrumentation / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology*; D010388:Pelvis; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*