title: Comparison of two minimally invasive approaches to endometrial cancer staging: a single-surgeon experience.
abstract: OBJECTIVE
  To compare the clinical outcomes of endometrial cancer staging procedures performed by a single surgeon utilizing traditional and robotic-assisted laparoscopic techniques.
  
  
  METHODS
  A retrospective review of minimally invasive endometrial cancer staging performed by a single surgeon.
  
  
  RESULTS
  There were no significant differences in operative time, blood loss, surgical complications, or length of hospitalization between laparoscopic (n = 45) and robotic-assisted (n = 77) procedures. On multivariable analysis controlling for surgical chronology, robotic assistance was independently associated with a significantly greater number of lymph nodes (23 vs. 19, p < 0.05; beta 0.163, p < 0.05). When comparing the first chronologic half of robotic-assisted surgeries to the second half, the latter had shorter operative time (208 vs. 246 min, p = 0.01) and a greater number of lymph nodes (27 vs. 19, p = 0.001). Finally, compared to the laparoscopic cases, the second half of robotic-assisted cases had a greater number of total (27 vs. 19, p < 0.001) and pelvic (23 vs. 17, p < 0.001) lymph nodes harvested.
  
  
  CONCLUSIONS
  There was a learning curve associated with robotic-assisted laparoscopic endometrial cancer staging, with decreased operative time and increased lymph node yield over time. In our study population, robotic assistance was independently associated with a greater lymph node harvest with no increase in operative time or perioperative complications.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Frey
authors.forename: Jeff F
authors.initials: JF
authors.lastname: Lin
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Stewart
authors.forename: Lena
authors.initials: L
authors.lastname: Makaroun
authors.forename: Vinicius José Andreotti
authors.initials: VJ
authors.lastname: Panico
authors.forename: Kevin
authors.initials: K
authors.lastname: Holcomb
mesh_terms: D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008197:Lymph Node Excision; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures