Evaluating postoperative pain and satisfaction among women treated by robotic surgery for gynecologic cancer

Background: Postoperative pain is frequently undermanaged in spite of advancements in pharmacologic and non-pharmacologic therapies for pain. Minimally invasive surgery is a promising surgical technique associated with reduced postoperative pain. The current study evaluates satisfaction following robotically-assisted surgery and its impact on short-term and long-term patient-rated pain. Methods: Prospective study on all consecutive patients (n=367) undergoing robotic surgery in the division of gynecologic oncology from December 2009 to December 2012. Patients were invited to complete questionnaires before surgery and at 1 week, 3 weeks, 3, 6, and 12 months after surgery. The brief pain inventory (BPI) was used to evaluate patient-rated pain severity, interference of pain with daily life, and treatments taken for pain. Results: After controlling for preoperative factors, both pain severity and pain interference with daily life returned to pre-surgery levels within three weeks of surgery. Patients using opioids for pain relief remained very low, varying from 2% at baseline to 11% during the first week, returning to 5% by the third week. By the first week post-surgery, the vast majority of patients expressed high satisfaction with an average score of 91%. Conclusions: Robotic surgery for the treatment of gynecologic cancers results in a minimal impact on short- and long-term patient-rated pain. The majority of patients (~90%) did not require the use of opioids and were very satisfied with their surgery.