title: Evidence for the use of robotically assisted surgery in gynecologic cancers.
abstract: Robotically assisted laparoscopy has been introduced in the armamentarium of gynaecologic oncology surgeons. A lot of studies compared robotic surgery and laparotomy when the real issue is to demonstrate the interest and added value of robotically assisted laparoscopy versus standard laparoscopy. In this review, we will describe the most meaningful indications and advantages of robotically assisted laparoscopy in gynaecologic oncology.
  
  
  
  The learning curve for advanced procedures in robot-assisted laparoscopy is shorter and easier than with the standard laparoscopy, especially for beginners. In most of the series, operating time is longer with robot, but complication rates are often decreased, especially in obese patients with a conversion rate to laparotomy that is decreased compared with standard laparoscopy. Robot-assisted laparoscopy can be used for surgery of high-risk endometrial cancer, staging of early-ovarian cancer, and pelvic exenteration in case of recurrent malignancies. Furthermore, more recent robots allow performing sentinel node biopsy in endometrial or cervical cancer using fluorescence detection with indocyanine green.
  
  
  
  The spreading of robotic surgery led to an enhancement of minimal invasive surgical approach in general, and to the development of new indications in gynaecologic oncology. The superiority of robot-assisted laparoscopy still has to be demonstrated with properly designed trials.
authors.affiliation: aGynecologic Oncology Expert Center, Paris Descartes, Hôpital Européen Georges Pompidou, APHPbFaculté de Médecine, Université Paris Descartes; Sorbonne Paris CitécUMR-S 1147, Faculté de Médecine, Université Paris DescartesdUMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ngô
authors.forename: Caroline
authors.initials: C
authors.lastname: Cornou
authors.forename: Léa
authors.initials: L
authors.lastname: Rossi
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Bats
authors.forename: Chérazade
authors.initials: C
authors.lastname: Bensaid
authors.forename: Albane
authors.initials: A
authors.lastname: Frati
authors.forename: Claude
authors.initials: C
authors.lastname: Nos
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lécuru
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D065287:Robotic Surgical Procedures / Q000379:methods*