Advancing Patient Care : Robotic Surgery Cases Catalog and Insights from a Tertiary Care Centre

ABSTRACT PURPOSE – Minimal invasive approach like robotics have precise anatomical interference, minimal instrumentation enhancing faster postoperative recovery, lesser pain, blood loss . Robotic-assisted surgery has revolutionized the field of gynecologic oncology, offering improved precision, dexterity, and visualization. In this article, we present our experience with 162 robotic surgeries using the da Vinci Xi system. We discuss surgical outcomes, complications, and advancements in the field, highlighting the benefits, challenges in the management of gynecological malignancies. METHODS – Data was collected retrospectively for robotic assisted gynaecological, gynaeoncological procedures from 2021 - 2024 April . Operative time, mean blood loss, hospital stay, perioperative complications, histopathology reports were analyzed . RESULTS – 162 patients were studied, comprising 94 benign pathology and 68 malignancies. In benign cases, robotic hysterectomies (85), ovarian cystectomies (7), sacrocolpopexy (1), colpopectopexy (1) . 68 malignancies included type 2, type 3 radical hysterectomies , robotic assisted video endoscopic inguinal lymphadenectomy ( RA – VEIL ) and pelvic, paraaortic, inguinal lymph nodes dissection . The mean hospital stay was 24 hours postoperatively with estimated blood loss of 25 ml in benign, 60 – 80 ml for malignant cases . We faced 2 intraoperative complications . Our nodal yield was an average 35 nodes using the sensitive firefly technique . CONCLUSIONS - Our experience can reinforce the feasibility, technical superiority, skills of robotics in gynaecology and gynaeoncology . KEYWORDS – Radical hysterectomy, Sentinel, robotic assisted video endoscopic VEIL.摘要 ## 目的 以机器人手术为代表的微创术式可实现精准的解剖操作，微创器械的使用可加快患者术后恢复、减轻疼痛与术中失血量。机器人辅助手术已彻底革新妇科肿瘤学领域，可提供更优异的精准度、操作灵活性与可视化效果。本文回顾本中心使用达芬奇Xi手术系统（da Vinci Xi system）完成的162例机器人手术的临床经验，探讨手术结局、并发症及该领域的研究进展，重点阐述其在妇科恶性肿瘤诊疗中的优势与挑战。 ## 方法 本研究回顾性收集2021年至2024年4月期间收治的机器人辅助妇科手术、妇科肿瘤手术患者的临床数据，对手术时长、平均失血量、住院时长、围手术期并发症及病理组织学报告进行分析。 ## 结果 本研究共纳入162例患者，其中94例为良性病变，68例为恶性病变。良性病变患者中，行机器人辅助子宫切除术85例、卵巢囊肿剥除术7例、骶骨阴道固定术1例、阴道旁固定术1例。68例恶性病变患者接受的手术包括2型、3型根治性子宫切除术、机器人辅助视频内镜腹股沟淋巴结清扫术（RA-VEIL）以及盆腔、腹主动脉旁及腹股沟淋巴结清扫术。良性病变患者术后平均住院时长为24小时，平均失血量为25ml；恶性病变患者平均失血量为60~80ml。本中心共发生2例术中并发症，采用灵敏萤火虫显像技术时，平均淋巴结获取数为35枚。 ## 结论 本研究经验可佐证机器人手术在妇科及妇科肿瘤领域的可行性、技术优越性与应用价值。 ## 关键词 根治性子宫切除术，前哨（Sentinel），机器人辅助视频内镜VEIL术