Cervical Cancer - Surgery

Radical hysterectomy in early cervical cancer less than 2 cm is associated with specific morbidity. Urinary disorders are often noticed and can depend on pelvic plexus nerve injuries. The purpose was to compare surgical and short-term outcomes, as well as urinary disorders between robotic-assisted nerve-sparing radical hysterectomy and laparoscopic no nerve-sparing radical hysterectomy. The first 19 cases of robotically assisted nerve-sparing type C1 radical hysterectomy for early cervical cancer less than 2 cm were compared with the 28 previous cases of open-laparoscopy type B radical hysterectomy. The two groups were comparable in terms of age, BMI and tumor size. There was no significant difference with median of blood loss. Robotic hysterectomy was associated with a shorter hospital stay median (4 vs. 5 days, p<0.01). The median operating time was significantly longer in the robotic group (290 vs. 240 min, p<0.05). The nerve-sparing procedure was performed in every robotic-assisted radical hysterectomy and no intra-operative complication was noticed. There was no problem with margins status in the robotic group and no significant difference in the median lymph nodes (23 vs. 26) We noticed more post-operative urinary retention (7 vs. 2) in the laparoscopic group. Robotic-assisted nerve-sparing radical hysterectomy can be considered as a feasible and safe procedure. Using the robotic system can help to preserve the autonomic nerve and therefore, can decrease the bladder dysfunction and improve the quality of life of these young patients.