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使用模块化多臂手术机器人系统Versius®(剑桥医疗机器人公司)对明显早期子宫内膜癌进行前哨淋巴结活检的机器人辅助手术分期:病例系列

Robotic-Assisted Surgical Staging with Sentinel Node Biopsy for Apparently Early-Stage Endometrial Cancer Using the Modular Multi-Arm Surgical Robot System Versius® (Cambridge Medical Robots): A Case Series.

作者信息

Uccella Stefano, Galli Liliana, Casprini Chiara, Festi Anna, Bosco Mariachiara, Zorzato Pier Carlo, Caraffini Andrea, Del Prete Biancamaria, Giacopuzzi Simone, Favilli Alessandro, Franchi Massimo, Bravi Callisto Marco, Garzon Simone

机构信息

Unit of Obstetrics and Gynecology, Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona, University of Verona, Verona, Italy.

Unit of General and Upper Gastrointestinal Surgery, Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona, University of Verona, Verona, Italy.

出版信息

Gynecol Obstet Invest. 2024 Dec 23:1-9. doi: 10.1159/000543122.

Abstract

OBJECTIVES

The aim of the study was to report the first cases of surgical staging for apparently early-stage endometrial cancer performed using the Versius® next-generation robotic surgical system (Cambridge Medical Robots [CMR] Surgical, Cambridge, UK).

DESIGN

The study used a prospective case series. Participants/Materials: Women who underwent surgical staging, including total hysterectomy, bilateral adnexectomy, and sentinel lymph node (SLN) biopsy, for apparently early-stage endometrial cancer using the Versius® next-generation robotic surgical system (CMR Surgical, Cambridge, UK) were included.

SETTING

The study was conducted at a Gynecologic Oncology Referral Center.

METHODS

We prospectively recorded data of all consecutive women who underwent the investigated surgical procedure.

RESULTS

Fourteen endometrial cancer patients were treated between March and August 2024 at the Azienda Ospedaliera Universitaria Integrata of Verona. The mean age was 69.4 ± 8.7 years, and the average body mass index was 27.2 ± 4.8. SLN biopsy was performed on all patients: 5 patients had unilateral and 9 bilateral successful SLN detection; 6 women underwent systematic pelvic lymphadenectomy in the unmapped areas. The median operative time was 122 (min-max, 77-185) minutes, and the median hysterectomy time was 34 (min-max, 18-68) minutes. None of the surgical procedures required conversion to conventional laparoscopic or open surgery for technical reasons, and no intraoperative complications were recorded. No readmissions, reoperations, or deaths were observed during the follow-up (median 102 days, min-max 39-249).

LIMITATIONS

The limitations of the study are the first experience in a limited study population and the use of methylene blue for SLN mapping.

CONCLUSIONS

Our preliminary results with the Versius® platform appear encouraging regarding surgical time, blood loss, rate of completion of the robotic procedures, and complications risk. Further studies will confirm the indications, feasibility, and safety of the Versius® surgical robot system for treating apparently early-stage endometrial cancer.

摘要

目的

本研究旨在报告首例使用Versius®下一代机器人手术系统(英国剑桥的剑桥医疗机器人公司[CMR]外科)对明显早期子宫内膜癌进行手术分期的病例。

设计

本研究采用前瞻性病例系列。参与者/材料:纳入了使用Versius®下一代机器人手术系统(英国剑桥的CMR外科)对明显早期子宫内膜癌进行手术分期(包括全子宫切除术、双侧附件切除术和前哨淋巴结[SLN]活检)的女性。

地点

本研究在一家妇科肿瘤转诊中心进行。

方法

我们前瞻性地记录了所有连续接受所研究手术的女性的数据。

结果

2024年3月至8月期间,维罗纳大学综合医院共治疗了14例子宫内膜癌患者。平均年龄为69.4±8.7岁,平均体重指数为27.2±4.8。所有患者均进行了SLN活检:5例患者单侧SLN检测成功,9例双侧成功;6名女性在未标记区域进行了系统性盆腔淋巴结清扫术。中位手术时间为122(最小值-最大值,77-185)分钟,中位子宫切除时间为34(最小值-最大值,18-68)分钟。所有手术均未因技术原因转为传统腹腔镜手术或开放手术,且未记录术中并发症。随访期间(中位102天,最小值-最大值39-249)未观察到再次入院、再次手术或死亡情况。

局限性

本研究的局限性在于研究人群有限的首次经验以及使用亚甲蓝进行SLN定位。

结论

我们在Versius®平台上的初步结果在手术时间、失血情况、机器人手术完成率和并发症风险方面似乎令人鼓舞。进一步的研究将证实Versius®手术机器人系统治疗明显早期子宫内膜癌的适应症、可行性和安全性。

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