Robot-assisted surgery improves outcomes in uterine, endometrial, and cervical cancer patients

Virtually eliminates need for narcotic painkillers, cuts hospital stays

Robot-assisted surgery dramatically improves outcomes in patients with uterine, endometrial, and cervical cancer, said researchers at the Jewish General Hospital's Lady Davis Institute for Medical Research in Montreal. Moreover, because of fewer post-operative complications and shorter hospital stays, robotic procedures also cost less.

These results were published in late 2010 in a series of studies in The Journal of Robotic Surgery and The International Journal of Gynecological Cancer.

To date, adoption of robotic surgery has been slowed by fears that it will raise overall healthcare costs. In Canada, robotic procedures are not yet covered by any provincial healthcare plan.

"To the contrary, robotic surgery definitely benefits patients and society," said Dr. Walter H. Gotlieb, Head of Gynecologic Oncology at the JGH Segal Cancer Centre. "Patient quality of life is dramatically improved, their hospital stays are much shorter and they use far less narcotic pain medication. The majority of our patients need nothing stronger than Tylenol."

In a robot-assisted operating room, the physician sits at a computer console and manipulates multiple robot arms, rather than working directly on the patient. The technology was developed to overcome the limitations of minimally invasive surgery (MIS), including such notoriously difficult procedures as laparoscopy for cancer.

"Laparoscopy is the gold standard of treatment for endometrial cancer, but unfortunately the learning curve is too steep for most surgeons," said Dr. Gotlieb, also Director of Surgical Oncology at McGill University. "A recent U.S. study said that only about six percent of gynecologic oncology surgeons offer laparoscopy to most of their endometrial cancer patients, despite its well-established advantages."

"At the Jewish General Hospital, we went from only 15 percent of our endometrial cancer patients benefiting from MIS by laparoscopy to 95 percent using robotic surgery. In cervical cancer we did not perform MIS at all before, whereas now all of our patients benefit from it."

Moreover, contrary to Isaac Asimov and other 20th-century science fiction writers, who predicted that people would react to robots with fear and loathing, patients - even elderly patients- are the most enthusiastic boosters of robotic surgery.

In a letter addressed to the hospital's director of professional services, one patient with a very complex case of endometrial cancer heaped praise on her "surgeon and his robot" and called the device a "marvel."