Robotic Laparoscopy May Have Easier Recovery For Patients With Early-Stage, Low Risk Endometrial Cancer

According to a randomized controlled trial, robotic laparoscopy led to a reduced inflammatory response, less tissue damage, and lower stress levels among patients with early endometrial cancer, when compared to conventional laparoscopy. However, the differences in these levels were transient.

In this single-center trial, 80 patients with early-stage, low risk endometrial cancer were randomized to undergo either robotic laparoscopy or conventional laparoscopy. Blood samples taken both pre- and post-surgery (at admission, immediately prior to surgery, 2 hours post-surgery, 24 hours post-surgery, 48 hours post-surgery, and 1 week post-surgery) were analyzed for biomarkers associated with inflammatory processes and tissue damage. The panel of biomarkers assessed included white blood cells, platelets, high sensitivity C-reactive protein, interleukin-6, creatine kinase, tumor necrosis factor-α, and cortisol. Study authors wrote that these markers have “previously been shown to reflect acute inflammation and response to tissue damage after surgery and stress.”

While pre-surgical preparation time was longer for patients in the robotic laparoscopy arm, there was also shorter operating time, quicker vaginal cuff closures, and lower estimated blood loss for these patients, compared to those who underwent conventional laparoscopy. Patients who underwent robotic laparoscopy also had shorter hospital stays, lower Visual Analog Scale pain scores, and decreased drainage volumes on the first postoperative day compared to those who underwent conventional laparoscopy. Levels of biomarkers associated with inflammation and tissue damage were notably lower among patients in the robotic laparoscopy arm, however the difference was transient. 

Study authors concluded, “robotic hysterectomy, when used in early endometrial cancer treatment, results in a reduced inflammatory response, diminished tissue damage, and a lesser stress reaction...” however, “variations in these markers were transient.” They also noted that “reduced tissue damage observed in the robotic group may lead to a quicker improvement in patient-reported health-related quality of life.”

Source:

Meng S, Cao Y, Shen Q, Dong L, Wang N. Comparison of tissue damage and inflammation for robotic laparoscopy and conventional laparoscopy in early endometrial cancer. Front Med. Published online: October 31, 2024. doi:10.3389/fmed.2024.1492469