Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: Outcomes and impact on approach Journal Article


Authors: Leitao, M. M. Jr; Briscoe, G.; Santos, K.; Winder, A.; Jewell, E. L.; Hoskins, W. J.; Chi, D. S.; Abu-Rustum, N. R.; Sonoda, Y.; Brown, C. L.; Levine, D. A.; Barakat, R. R.; Gardner, G. J.
Article Title: Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: Outcomes and impact on approach
Abstract: Objective: To assess the introduction of computer-based surgery (ie, robotic surgery [RBT]) in the treatment of patients with newly diagnosed uterine cancer. Methods: We identified all patients who presented to our institution for initial surgical care of newly diagnosed uterine cancer from 5/1/07-12/31/10. Perioperative outcomes of laparotomy cases were compared to those of laparoscopic (LSC) or RBT cases. Complications within 30 days of surgery were graded. Results: Of 752 patients, the planned approach was laparotomy in 103 (14%), LSC in 302 (40%), and RBT in 347 (46%). The rate of laparotomy for any reason (planned or converted) was 39% in 2007 compared to 18% in 2010 (P < 0.001). Preoperative characteristics for LSC and RBT cases were similar, except 10% versus 15%, respectively, were morbidly obese (P = 0.049). The extent of procedure, total nodal counts, and overall complications were similar between the LSC and RBT cases. The median length of stay was shorter for RBT cases (P < 0.001). The median total room and operative times were longer for RBT cases (P < 0.001), mainly due to cases in which the surgeon had less than ~ 40 RBT cases of experience. Conclusions: Robotics can be efficiently introduced into the surgical care of patients with newly diagnosed uterine cancers. RBT cases require the same operative times as LSC cases after accounting for the 40-case learning curve. Both approaches result in similar excellent patient outcomes and remain reasonable approaches for this disease. The introduction of robotics may lead to further reduction in the rate of laparotomy. © 2012 Elsevier Inc. All rights reserved.
Keywords: laparotomy; uterine cancer; robotic surgery; computer-based surgery
Journal Title: Gynecologic Oncology
Volume: 125
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2012-05-01
Start Page: 394
End Page: 399
Language: English
DOI: 10.1016/j.ygyno.2012.01.046
PROVIDER: scopus
PUBMED: 22307063
DOI/URL:
Notes: --- - "Export Date: 1 May 2012" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Ginger J Gardner
    271 Gardner
  2. Elizabeth Jewell
    131 Jewell
  3. William Hoskins
    255 Hoskins
  4. Richard R Barakat
    629 Barakat
  5. Carol Brown
    167 Brown
  6. Dennis S Chi
    710 Chi
  7. Yukio Sonoda
    473 Sonoda
  8. Douglas A Levine
    380 Levine
  9. Mario Leitao
    576 Leitao
  10. Kevin Santos
    8 Santos
  11. Abigail Duncan Winder
    1 Winder