Current Surgical Treatment of Endometrial Carcinoma: The Role of Robotic Surgery

Endometrial cancer is among the most common malignancies in women, and its incidence is on the rise. Treatment is primarily surgical, with hysterectomy, sentinel lymph node biopsy, and lymphadenectomy performed either by laparotomy or laparoscopy. Robotic surgery constitutes a novel approach to endometrial cancer treatment, promising to combine the efficacy of open surgery with the swift recovery and lower morbidity of minimally invasive techniques. Literature data suggest that robotic surgery is associated with better surgical outcomes, including reduced blood loss, lower complication rates, decreased transfusion rates, shorter length of hospital stay, and lower re-admission rates compared to open surgery. This is also the case for laparoscopy with regard to the length of hospital stay and the rate of conversion to open surgery. The surgical benefits of robotic surgery seem even more pronounced for obese and elderly endometrial cancer patients. Robotic surgery also offers improved pain-related outcomes, with significantly lower opioid consumption and reduced pain intensity compared to both alternatives. Oncological outcomes appear consistent regardless of the surgical approach, with the exception of a benefit in overall survival and recurrence rates for robotic surgery compared to laparotomy. Minimally invasive surgery appears to be the way forward in the treatment of endometrial cancer, with robotic surgery in particular offering several advantages over conventional alternatives, especially for high-risk patient subgroups. Additional studies accounting for disease surgical and molecular classification stages will assist in further investigating the benefits of modern technology and in establishing additional patient subcategories who would benefit most from the application of robotic technology.