Benefit of robot-assisted laparoscopy in nerve-sparing radical hysterectomy: urinary morbidity in early cervical cancer

Surg Endosc. 2013 Apr;27(4):1237-42. doi: 10.1007/s00464-012-2582-z. Epub 2012 Oct 18.

Abstract

Objective: To evaluate the feasibility of nerve-sparing radical hysterectomy in early cervical cancer by robot-assisted laparoscopy and atonic bladder rate.

Methods: This was a retrospective study with consecutive patients in three gynecological oncology departments. Patients with <2 cm cervical cancer had nerve-sparing radical hysterectomy by robot-assisted laparoscopy and pelvic lymphadenectomy. Two days after surgery, we systematically removed the Foley bladder catheter.

Results: The median (range) age and body mass index of the 30 patients were 44 (33-68) years and 23.9 (17.7-39.4) kg/m(2), respectively. The median (range) tumor diameter at the time of surgery was 13 (4-38) mm. The median (range) operative time, blood loss, and number of pelvic lymph nodes (any common iliac lymph nodes) were 305 (180-405) min, 100 (30-1,500) ml, and 18 (7-28). The overall complication rate was 52.3 %, of which 6.7 % atonic bladder. Twenty-eight patients (93.3 %) were discharged 2 days after surgery with spontaneous voiding and no residual urine >100 ml.

Conclusions: Nerve-sparing radical hysterectomy by robot-assisted laparoscopy is feasible in early cervical cancer (<2 cm). A total of 93.3 % of the patients were discharged 2 days after surgery with spontaneous voiding. The next step would be a prospective study with objective urodynamic investigations.

MeSH terms

  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy / methods*
  • Middle Aged
  • Organ Sparing Treatments
  • Retrospective Studies
  • Robotics*
  • Urination Disorders / epidemiology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*