Early feasibility surveillance of gynecologic robotic‐assisted surgeries in Japan

• Published in: The journal of obstetrics and gynaecology research Vol. 45; no. 4; pp. 787 - 793
• Main Authors: Baba, Tsukasa, Mandai, Masaki, Nishi, Hirotaka, Nishii, Osamu, Kitawaki, Jo, Sawada, Morio, Isaka, Keiichi, Fujii, Tomoyuki
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.04.2019; Wiley Subscription Services, Inc
• Subjects: Aorta; Gynecology; Hospitals; Hysterectomy; Japanese Society of Obstetrics and Gynecology; Obstetrics; para‐aortic node excision; radical hysterectomy; Robotic surgery; robotic‐assisted surgery; Surveillance; radical hysterectomy; Japanese Society of Obstetrics and Gynecology; robotic-assisted surgery; para-aortic node excision
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.13923

Aim To evaluate the clinical relevance of robotic‐assisted surgeries (RAS) for gynecologic malignancies in a Japanese multi‐institutional cohort. Methods A retrospective review of perioperative outcomes of 357 gynecologic RAS procedures was conducted in 24 hospitals accredited to perform RAS by the Japanese Society of Obstetrics and Gynecology (JSOG) over a 4‐year period, January 2014 to December 2017. Results More than 25 (high), 10–24 (middle) and less than 10 cases (low) were enrolled from 3, 8 and 13 hospitals, respectively. A total of 247 patients underwent RAS for malignant indications. Radical hysterectomy (RH) was conducted for 200 patients, while para‐aortic node excision (PAN) for 47 patients. RAS with RH or PAN was more feasible in high‐volume centers with significantly shorter operation time and lesser blood loss than that in middle‐volume centers. The total rate of perioperative injury and complications in RAS with PAN reached 33.3% in high‐volume centers, which was almost equal to those in middle‐volume centers (35.5%) but much higher than RAS without PAN (8.5%). Conclusion Perioperative surveillance demonstrated high feasibility of gynecologic RAS procedures conducted in JSOG accredited hospitals for these 4 years. It is mandatory for RAS conducting hospitals to have careful attitudes to realize their learning curves in conducting advanced procedures.