W.-M. Liu

Comparison of Perioperative Complications Between of Robotics and Laparoscopy Approaches in the Management of Gynecologic Malignances

Design: Case Report. Setting: Academic hospital in Mexico. Patients: A woman with a symptomatic uterine fibroid resulting in abnormal uterine bleeding. Intervention: Transcervical radiofrequency ablation of uterine fibroids. Measurements and Main Results: This is a report on a pregnancy that occurred in a multigravida after transcervical radiofrequency ablation of a type 1 myoma with the Sonata System, which includes an integral intrauterine sonography probe for imaging in concert with a graphical targeting system. The patient underwent successful treatment and noted amenorrhea at her six-month visit. Prior to that time she had reported a decrease in her menstrual bleeding and fibroid symptoms, and a contrast-enhanced MRI noted significant reductions in perfused and total fibroid volumes. The patient proceeded to term and delivered a viable infant via elective repeat Cesarean section with Apgar scores of 91 and 105. There was no evidence of an ablated fibroid or of any myometrial defect at the time of hysterotomy. Conclusion: This first report of a term pregnancy after treatment with the Sonata System adds to the growing literature base suggesting compatibility between hyperthermic ablation (focused ultrasound, radiofrequency ablation) and pregnancy.

Detection of Sentinel Lymph Node Mapping Using Indocyanine Green in the Management of Endometrial Cancer: A Pilot Study

Study Objective: To compare perioperative complications of roboticassisted and laparoscopic-assisted staging surgery in management of gynecologic malignances. Design: Retrospective cohort study. Setting: University-affiliated teaching hospital. Patients: Four hundred thirteen women who underwent robotic-assisted (n=210) and laparoscopic-assisted (n=203) procedures between December 2011 and February 2015 were identified for analysis. Intervention: Of all 413 women who underwent surgical treatment for gynecologic malignances, 256 received staging surgery for endometrial cancer (robotics 106 and laparoscopy 150), 80 received staging surgery for ovarian cancer (robotics 59 and laparoscopy 21), and 77 received radical hysterectomy for cervical cancer (robotics 45 and laparoscopy 32). Patient demography, surgical outcomes and complications were evaluated. Measurements and Main Results: The mean ages and BMI were 52.6 12.2 and 24.3 4.5 for robotic group, and 50.4 13.5 and 24.9 5.0 for laparoscopic group, respectively, with no significant differences between two groups. The overall complication rates were 8.6% for robotic-assisted surgery and 6.9%, respectively. No significant difference was found between groups. Conclusion: Robotic-assisted surgery is a feasible approach inmanagement of gynecologic malignances with an acceptable complication rate, as compared to laparoscopic-assisted approach.