Robotic surgery in gynaecology and gynaecological oncology: Program initiation and operative outcomes at the Royal Adelaide Hospital

Abstract

Background: Robotic surgery has become an integral part of gynaecological surgery in the USA. In Australia, however, robotic surgery has only been established in urologic and cardiac surgery. In 2008, the Royal Adelaide Hospital (RAH) was the first public hospital to initiate a robotic surgery program in gynaecology and gynaecological oncology in Australia. Aims: To evaluate the feasibility and outcome of the robotic surgery program in gynaecology and gynaecological oncology at the RAH. Methods: A prospective case series analysis of the first 71 patients operated by robotic surgery from August 2008 to May 2010 was performed. Results: All patients underwent a total or radical robotic hysterectomy with or without staging for gynaecological cancer, benign disease or genetic risk. No conversions to laparotomy were required. Sixty-seven patients (95%) were discharged the morning after surgery. Four patients (5%) required hospital stays of up to 3 days because of pre-existing medical conditions or logistical reasons. The only major postoperative complication was one vault dehiscence. Minor short-term problems in four patients were vaginal cuff cellulitis, vaginal vault granulation tissue and infected port sites. Conclusion: The RAH experience is that robotic surgery in gynaecology and gynaecological oncology is safe and feasible. Patient recovery is excellent, and the hospital stay is reduced. Robotic surgery has the potential to significantly expand the minimally invasive surgical options for women undergoing surgery for benign and malignant gynaecological disease in Australia.