Vaginal robot‐assisted radical hysterectomy (VRARH) after laparoscopic staging: feasibility and operative results

Abstract

BACKGROUND: To describe a technique of vaginal robot-assisted radical hysterectomy (VRARH) that utilizes the advantages of a robotic system and eliminates the manipulation of cancer tissue. METHODS: A prospective study was performed for VRARH using the da Vinci robotic surgical system in 12 patients. The procedure was indicated in patients with cervical cancer stage FIGO IB1 after laparoscopic lymphadenectomy. A tumour-adapted vaginal cuff was created transvaginally. RESULTS: All operations were completed with minimal blood loss (mean 123 ml). The mean operative time including para-aortic lympadenectomy was 356 min, the vaginal cuff creation took 43 min and the radical robotic resection 68 min. No uterine manipulator was used. There were no bladder or bowel complications and no conversion to standard laparoscopy or laparotomy. CONCLUSIONS: The VRARH technique combines the advantages of the vaginal route and robotic laparoscopic surgery: tumour contamination is avoided and complications are minimized. This procedure could be superior to techniques described previously.