title: TELELAP ALF-X Robotic-assisted Laparoscopic Hysterectomy: Feasibility and Perioperative Outcomes.
abstract: OBJECTIVE
  To show the safety, feasibility, and perioperative outcomes of total TELELAP ALF-X hysterectomy (SOFAR S.p.A., ALF-X Surgical Robotics Department, Trezzano Rosa, Milan, Italy).
  
  
  METHODS
  Phase II study (Canadian Task Force II-2).
  
  
  METHODS
  Catholic University of the Sacred Heart, Rome, Italy.
  
  
  METHODS
  From October 2013 to May 2014, 80 women underwent total TELELAP ALF-X hysterectomy. The study population was divided into 2 groups according to surgical procedures: total hysterectomy ± bilateral salpingo-oophorectomy (group 1) and endometrial cancer patients staged with pelvic lymphadenectomy (group 2).
  
  
  METHODS
  Total TELELAP ALF-X hysterectomy ± bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy.
  
  
  RESULTS
  The median age was 51 years (range, 48-79), and the median body mass index was 24 kg/m(2) (range, 17.3-34.2). Forty-five patients (56.2%) had previous surgery. The median operative time was 140 minutes (range, 58-320) in group 1 and 197 minutes (range, 129-290) in group 2 (p < .001). The median docking time was 8 minutes (range, 3-25). During the study period, a significant trend in operative time reduction was observed. Procedures were successfully performed without conversion in 93.7% of cases. We observed 2 (2.5%) intraoperative complications, 3 (3.7%) conversions to standard laparoscopy, and 2 (2.5%) to laparotomy. The median time to discharge was 2 days (range, 1-5). One patient (1.2%) was readmitted in the early postoperative period.
  
  
  CONCLUSIONS
  As new technology evolves, critical appraisal of patient-related outcomes, use, cost, and access to minimally invasive hysterectomy must remain a priority. Despite the relative small number of our series, we showed the feasibility and safety of total TELELAP ALF-X hysterectomy for benign and malignant disease.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: francesco.fanfani@rm.unicatt.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", University of Trieste, Trieste, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Restaino
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gueli Alletti
authors.affiliation: Minimally Invasive Gynecology, St. Maria Hospital, University of Perugia, Terni, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Monterossi
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Rossitto
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Costantini
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D007431:Intraoperative Complications / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000295:instrumentation*; D008875:Middle Aged; D061646:Operative Time; D010052:Ovariectomy / Q000295:instrumentation; D010351:Patient Discharge; D010388:Pelvis; D065287:Robotic Surgical Procedures; D058994:Salpingectomy / Q000295:instrumentation; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Hysterectomy; Laparoscopy; Robotic