Article thumbnail
Location of Repository

From open radical hysterectomy to robot-assisted laparoscopic radical hysterectomy for early stage cervical cancer: aspects of a single institution learning curve

By H. W. R. Schreuder, R. P. Zweemer, W. M. van Baal, J. van de Lande, J. C. Dijkstra and R. H. M. Verheijen


We analysed the introduction of the robot-assisted laparoscopic radical hysterectomy in patients with early-stage cervical cancer with respect to patient benefits and surgeon-related aspects of a surgical learning curve. A retrospective review of the first 14 robot-assisted laparoscopic radical hysterectomies and the last 14 open radical hysterectomies in a similar clinical setting with the same surgical team was conducted. Patients were candidates for a laparoscopic sentinel node procedure, pelvic lymph node dissection and open radical hysterectomy (RH) before August 2006 and were candidates for a laparoscopic sentinel node procedure, pelvic lymph node dissection and robot-assisted laparoscopic radical hysterectomy (RALRH) after August 2006. Overall, blood loss in the open cases was significantly more compared with the robot cases. Median hospital stay after RALRH was 5 days less than after RH. The median theatre time in the learning period for the robot procedure was reduced from 9 h to less that 4 h and compared well to the 3 h and 45 min for an open procedure. Three complications occurred in the open group and one in the robot group. RALRH is feasible and of benefit to the patient with early stage cervical cancer by a reduction of blood loss and reduced hospital stay. Introduction of this new technique requires a learning curve of less than 15 cases that will reduce the operating time to a level comparable to open surgery

Topics: Original Article
Publisher: Springer-Verlag
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2008). A brief review: anesthesia for robotic prostatectomy.
  2. (2008). A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy.
  3. (2009). A multi-institutional experience with robotic-assisted radical hysterectomy for early stage cervical cancer.
  4. (2008). Advincula AP
  5. AH et al (2009) Robotic-assisted sacrocolpopexy: technique and learning curve.
  6. (2008). Anesthesia considerations for robotic-assisted laparoscopic prostatectomy: a review of 1, 500 cases.
  7. (2007). Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training.
  8. (1990). Does endoscopic surgery have a role in radical surgery of cancer of the cervix uteri? J Gynecol Obstet Biol Reprod
  9. (2007). Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review.
  10. (1974). Five classes of extended hysterectomy for women with cervical cancer.
  11. III, Edwards RP et al (2008) Survival for stage IB cervical cancer with positive lymph node involvement: a comparison of completed vs. abandoned radical hysterectomy.
  12. Kenemans P et al (2003) Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer.
  13. (1992). Laparoscopic radical hysterectomy with paraaortic and pelvic node dissection.
  14. (2008). Learning curve and preliminary experience with da Vinci-assisted laparoscopic radical prostatectomy.
  15. Lurain JR et al (2009) A comparison of robot-assisted and traditional radical hysterectomy for early-stage cervical cancer.
  16. (2008). New techniques in radical hysterectomy. Curr Opin Obstet Gynecol 20(1):14–19 Gynecol Surg
  17. (2004). Obermair A
  18. (1997). Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer.
  19. (2009). Rivera A
  20. (2009). Robot assisted laparoscopic radical hysterectomy and pelvic lymphadenectomy with short and long term morbidity data.
  21. (2008). Robot radical hysterectomy.
  22. (2008). Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer.
  23. (2007). Robotic radical hysterectomy in earlystage cervical carcinoma patients, comparing results with total laparoscopic radical hysterectomy cases. The future is now?
  24. (2008). Robotic radical hysterectomy versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer.
  25. (2008). Robotic radical hysterectomy with pelvic lymphadenectomy for cervical carcinoma: a pilot study.
  26. (2008). Robotic radical hysterectomy: comparison with laparoscopy and laparotomy.
  27. (2009). Robotic surgery.
  28. (2004). Robotic technology in surgery: past, present, and future.
  29. (2008). Robotic versus open radical hysterectomy: a comparative study at a single institution.
  30. (2008). Roboticassisted gynaecological surgery-establishing training criteria; minimizing operative time and blood loss.
  31. (2000). Sentinel node detection in cervical cancer.
  32. (1912). The extended abdominal operation for carcinoma uteri.
  33. (1945). The Wertheim operation for carcinoma of the cervix.
  34. (2008). What is the learning curve for robotic assisted gynecologic surgery?

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.