Use of the vessel sealer in paraaortic lymphadenectomy in the robotic assisted approach in endometrial cancer

. 2025 Mar 10 ; 15 (1) : 8175. [epub] 20250310

Jazyk angličtina Země Velká Británie, Anglie Médium electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid40059118
Odkazy

PubMed 40059118
PubMed Central PMC11891311
DOI 10.1038/s41598-025-93044-y
PII: 10.1038/s41598-025-93044-y
Knihovny.cz E-zdroje

Minimally invasive surgery is the method of choice in endometrial cancer. Experience in procedures assisted by a robotic system is growing rapidly. One of the new bipolar ones is a Vessel Sealer, with sealing and cutting function. The aim of the study was to compare robotic surgery assisted with the da Vinci X system with use of the Vessel Sealer or without it. The study included 25 patients with high-risk endometrial cancer after completed pelvic and paraaortic lymphadenectomy with mean age 60.07 ± 10.67 (range 34.69-83.23) years divided into two groups: one with use of the Vessel Sealer; the second one only with monopolar scissors and subdivided by one-site versus dual docking. Duration of the operation was significantly associated with previous surgery (p < 0.005). Use of the Vessel Sealer was associated with lower blood loss during surgery (p < 0.05). The number of removal pelvic lymph nodes was higher in case of Vessel Sealer with no relation to BMI. Experience in robotic surgery allowed for shortened operation time and led to better outcomes. The Vessel Sealer used in robotic surgery appears to reduce blood loss during surgery and operation time, especially in the case of previous surgery, however, it increases costs of the procedure.

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Sung, H. et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Ca Cancer J. Clin.71, 209–249. 10.3322/caac.21660 (2021). PubMed

Urick, M. E. & Bell, D. W. Clinical actionability of molecular targets in endometrial cancer. Nat. Rev. Cancer. 19 (9), 510–521. 10.1038/s41568-019-0177-x (2019). PubMed PMC

Berek, J. S. et al. Concin, N. FIGO staging of endometrial cancer: 2023. Int. J. Gynecol. Obstet.162, 383–394. 10.1002/ijgo.14923 (2023). PubMed

Concin, N. et al. Creutzberg, C. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int. J. Gynecol. Cancer. 31, 12–39. 10.1136/ijgc-2020-002230 (2021). Bosse, T.Chargari, C., Fagotti, A., Fotopoulou, C., Gonzalez Martin, A., Lax, S., Lorusso, D., Marth, C., Morice, P., Nout, R., O’Donnell, D., Querleu, D., Raspollini, M., Sehouli, J., Sturdza, A., Taylor, A., Westermann, A., Wimberger, P., Colombo, N., Planchamp. PubMed

NCCN Clinical Practice Guidelines in. Oncology (NCCN Guidelines) Uterine Neoplasms Version 3.2024 – September 20, (2024).

Kim, H. J., Cho, A., Yun, M., Kim, Y. T. & Kang, W. J. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann. Nucl. Med.30 (2), 104–113. 10.1007/s12149-015-1037-8 (2016). PubMed

Legros, M. et al. Para-aortic lymph node invasion in High-risk endometrial cancer: performance of 18FDG PET-CT. Anticancer Re. 39 (2), 619–625. 10.21873/anticanres.13155 (2019). PubMed

Gota, T. et al. The current status of robotic surgery for endometrial cancer in Japan. Glob Health Med.28 (4), 21–25. 10.35772/ghm.2021.01077 (2022). PubMed PMC

Opitz, I., Gantert, W., Giger, U., Kocher, T. & Krähenbühl, L. Bleeding remains a major complication during laparoscopic surgery: analysis of the SALTS database. Langenbecks Arch. Surg.390, 128–133. 10.1007/s00423-004-0538-z (2005). PubMed

Campagnacci, R. et al. Electrothermal bipolar vessel sealing device vs. ultrasonic coagulating shears in laparoscopic colectomies: a comparative study. Surg. Endosc. 21, 1526–1531. 10.1007/s00464-006-9143-2 (2007). PubMed

Spinoglio, G., Summa, M., Priora, F., Quarati, R. & Testa, S. Robotic colorectal surgery: first 50 cases experience. Dis. Colon Rectum. 51, 1627–1632. 10.1007/s10350-008-9334-0 (2008). PubMed

Kennedy, J., Stranahan, P. & Taylor, K. High-burst-strenght, feedback-controlled bipolar vessel sealing. Surg. Endosc. 12, 876–878. 10.1007/s004649900733 (1998). PubMed

Shiber, L. et al. Comparison of Industry-Leading energy devices for use in gynecologic laparoscopy: articulating ENSEAL versus LigaSure energy devices. J. Minim. Invasive Gynecol.25, 467–473. 10.1016/j.jmig.2017.10.006 (2018). PubMed

Landman, J., Kerbl, K. & Rehman, J. Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic Gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a Porcine model. J. Urol.169, 697–700. 10.1097/01.ju.0000045160.87700.32 (2003). PubMed

Ortenzi, M., Ghiselli, R., Baldarelli, M., Cardinali, L. & Guerrieri, M. Is the bipolar vessel sealer device an effective tool in robotic surgery? A retrospective analysis of our experience and a meta-analysis of the literature about different robotic procedures by investigating operative data and post-operative course. Minim. Invasive Ther. Allied Technol.27, 113–118. 10.1080/13645706.2017.1329212 (2018). PubMed

Lee, H. J., Lee, Y. H., Chong, G. O., Hong, D. G. & Lee, Y. S. Comparison of robotic - assisted versus laparoscopy for transperitoneal infrarenal para-aortic lymphadenectomy in patients with endometrial cancer. J. Obstet. Gynaecol. Res.44, 547–555. 10.1111/jog.13535 (2018). PubMed

Lu, Y. et al. Application of robotic surgery and traditional laparoscopic surgery in lymph node dissection for gynecological cancer: A metaanalysis. Oncol. Lett.25, 175. 10.3892/ol.2023.13761 (2023). PubMed PMC

Levy, B. & Emery, L. Randomized trial of suture versus electrosurgical bipolar vessel sealing in vaginal hysterectomy. Obstet. Gynecol.102, 147–151. 10.1016/s0029-7844(03)00405-8 (2023). PubMed

Dubey, P. et al. Electrothermal vessel sealing versus conventional suturing in abdominal hysterectomy: A randomised trial. Cureus15, e34123. 10.7759/cureus.34123 (2023). PubMed PMC

Kyo, S. et al. Experience and efficacy of a bipolar vessel sealing system for radical abdominal hysterectomy. Int. J. Gynecol. Cancer. 19, 1658–1661. 10.1111/IGC.0b013e3181a840d1 (2009). PubMed

Achouri, A. et al. Complications of lymphadenectomy for gynecologic cancer. Eur. J. Surg. Oncol.39, 81–86. 10.1016/j.ejso.2012.10.011 (2013). PubMed

Weinberger, V., Cibula, D. & Zikan, M. Lymphocele: prevalence and management in gynecological malignancies. Expert Rev. Anticancer Ther.14, 307–317. 10.1586/14737140.2014.866043 (2014). PubMed

Zikan, M. et al. Cibula, D. A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadenectomy in patients with gynecological cancer. Gynecol. Oncol.137, 291–298. 10.1016/j.ygyno.2015.02.016 (2015). PubMed

Neagoe, O. C., Ionica, M. & Mazilu, O. The role of pelvic lymphocele in the development of early postoperative complications. Medicine97, e12353. 10.1097/MD.0000000000012353 (2018). PubMed PMC

Tam, K., Lam, K., Chan, K. & Ngan, H. Natural history of pelvic lymphocysts as observed by ultrasonoghraphy after bilateral pelvic lymphadenectomy. Ultrasound Obstet. Gynecol.32, 87–90. 10.1002/uog.5345 (2008). PubMed

Abaza, R., Henderson, S. & Martinez, O. Robotic vessel sealer device for lymphocele prevention after pelvic lymphadenectomy: Results of a randomized trial. J. Laparoendosc Adv. Surg. Tech. A. 32, 721–726. 10.1089/lap.2021.0531 (2022). PubMed

Lamblin, G. et al. Does ultrasonic advanced energy reduce lymphocele incidence in laparoscopic para-aortic lymphadenectomy? Eur. J. Obstet. Gynecol. Reprod. Biol.185, 53–58. 10.1016/j.ejogrb.2014.11.030 (2015). PubMed

Marek, R. et al. Robotic paraaortic lymphadenectomy in oncogynecology. Double side Docking of Da Vinci S system increases the success rates of high paraaortic lymph node dissection in endometrial cancer. Ceska Gynekol.84 (1), 4–17 (2019). PubMed

Loaec, C. et al. Dual Docking robotic surgical staging for high risk endometrial cancer. Eur. J. Obstet. Gynecol. Reprod. Biol.225, 79–83. 10.1016/j.ejogrb.2018.04.009 (2018). PubMed

Maenpaa, M. M., Nieminen, K., Tomas, E. I., Luukkaala, T. H. & Maenpaa, J. U. Robotic-assisted infrarenal Para-aortic lymphadenectomy in gynecological cancers: Technique and surgical outcomes. Int. J. Gynecol. Cancer. 28 (5), 951–958. 10.1097/IGC.0000000000001249 (2018). PubMed

Franke, O. et al. Role of a double Docking to improve lymph node dissection: When robotically assisted laparoscopy for para-aortic lymphadenectomy is associated to a pelvic procedure. Int. J. Gynecol. Cancer. 25 (2), 331. 10.1097/IGC0000000000000338 (2015). PubMed

Ponce, J. et al. Robotic transperitoneal infrarenal Para-Aortic lymphadenectomy with double docking: Technique, learning curve, and perioperative outcomes. J. Minim. Invasive Gynecol.23 (4), 622–627. 10.1016/j.jmig.2016.02.005 (2016). PubMed

Ponce, J. et al. Robotic-assisted para-aortic lymphadenectomy: Technique and indications in gynecological oncology. Best Pract. Res. Clin. Obstet. Gynaecol.91, 102401. 10.1016/j.bpobgyn.2023.102401 (2023). PubMed

Persyn, B. & Van Trappen, P. Robotic hysterectomy using a sealing device: differences in complications and pain scores between small and large Uteri. Surg. Technol. Int.28, 37:143–148 (2020). PubMed

Hoste, G. & Van Trappen, P. Robotic hysterectomy using the vessel sealer for myomatous Uteri: Technique and clinical outcome. Eur. J. Obstet. Gynecol. Reprod. Biol.194, 241–244. 10.1016/j.ejogrb.2015.09.030 (2015). PubMed

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