EP750 Experience of setting up a robotic surgery program for women with gynae cancers at a tertiary level cancer center in eastern india
2019
Introduction/Background The beginning of any robotic program can be challenging as multiple members of the team are learning the technology and their own personal roles on the team. Methodology The demographic and perioperative data of the first thirty patients were prospectively recorded. Surgeries done by mentors were excluded. Only surgeries done independently by in house consultants were included. Sentinel lymphnode biopsies were done using ICG dye and near infrared imaging (Firefly).The data was analysed using SPSS software. Results 30 women were included with a median age of 60.5 years and median BMI of 26.4. Robotic hysterectomy + BSO + SLNB ± PLND in 27 women with endometrial cancer. Two women with early cervical cancer underwent Robotic Type B hysterectomy + B/L PLND and one woman had robotic parametrectomy. Docking time ranged from 5 to 100 minutes (median 24.5 minutes). Console time ranged between 70 to 300 minutes (median 140 minutes). SLN mapping was done in 25 patient i.e 50 sites. Unilateral mapping were in 3 women and in another 5 there was no mapping in bilateral pelvis. Hence 37 sites were mapped out of 50 (74%). 18 women (60%) underwent B/L pelvic lymphadenectomy. All women were mobilised and started on diet at four hours from surgery. All women barring one were discharged within 24 hours of surgery. Histopathology revealed one patient with atypical hyperplasia (3.3%), one MMMT (3.3%), three SCC cervix (10%) and rest were endometrial cancer. Median SLN harvest was 2 (range 1–9) and pelvic lymphnode yield was 12 (range 9–45) per patient. Conclusion Robotic surgery provides definite benefits of minimal blood loss, excellent vision and dexterity and obviously minimal pain and shorter stay for the patients. It has a short learning curve. Adequate training and team formation are pivotal towards establishing a successful robotic program. Disclosure Nothing to disclose.
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