A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy

Am J Obstet Gynecol. 2008 Oct;199(4):360.e1-9. doi: 10.1016/j.ajog.2008.08.012.


Objective: The purpose of this study was to compare outcomes in women who underwent endometrial cancer staging by different surgical techniques.

Study design: Three hundred twenty-two women underwent endometrial cancer staging: 138 by laparotomy (TAH); 81 by laparoscopy (TLH) and 103 by robotic technique (TRH).

Results: The TRH cohort had a higher body mass index than the TLH cohort (P = .0008). Lymph node yield was highest for TRH (P < .0001); hospital stay (P < .0001) and estimated blood loss (P < .0001) were lowest for this cohort. Operative time was longest for TLH (213.4 minutes) followed by TRH (191.2 minutes) and TAH (146.5 minutes; P < .0001. Postoperative complication rates were lower for TRH, compared with TAH (5.9% vs 29.7%; P < .0001). Conversion rates for the robotic and laparoscopic groups were similar.

Conclusion: TRH with staging is feasible and preferable over TAH and may be preferable over TLH in women with endometrial cancer. Further study is necessary to determine long-term oncologic outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical / statistics & numerical data
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Hysterectomy*
  • Laparoscopy
  • Laparotomy
  • Length of Stay
  • Lymph Node Excision
  • Middle Aged
  • Neoplasm Staging / methods*
  • Ovariectomy
  • Robotics*
  • Treatment Outcome