vv 022 Citation: Ferreira ÉL, Nunes JC, Zandoná M, Perret C, Fiorelli R, et al. (2019) Complications of Robotic Surgery in Oncological Gynecology: The Experience of the Brazilian National Institute of Cancer. J Gynecol Res Obstet 5(2): 022-025. DOI: http://dx.doi.org/10.17352/jgro.000065 https://dx.doi.org/10.17352/jgro DOI: 2581-5288 ISSN: CLINICAL GROUP Research Article Complications of Robotic Surgery in Oncological Gynecology: The Experience of the Brazilian National Institute of Cancer Introduction The number of surgeries performed with robotic equipment has increased ever since its release by the Food and Drug Administration (FDA) in 2005 [1]. Robotic surgery is well accepted and seems to be as effective as laparoscopy in the treatment of endometrial and cervix cancers [2,3]. Some of the advantages of using this method over the traditional laparoscopic technique include 3D visualization, tremor filtration, greater dexterity, better ergonomics, lower blood loss and lower post-operative pain index [4]. In spite of some known limitations, such as the limited view of the 4 surgical quadrants when using Da Vinci® series S and Si, robotic surgery is now widely used in the United States [5]. Furthermore, this limitation has been correct by the newest Da Vinci® series XI, increasing the effectiveness of the method. With this updates in technology, the American Society of Gynecologic Oncology (SGO) now recognizes robotic surgery as a changer in gynecologic cancer treatment paradigms [6]. To the present moment, 3200 robotic platform exist in the world (2223 in the USA, 549 in Europe and 494 in the rest of the world). Also, in the United States 95% of the gynecologic oncologists have these platforms in their institutions and have been trained to use them [7]. The objective of this study is to assess the complications and outcomes of gynecological cancer cases treated with robotic surgery at the Brazilian National Institute of Cancer (INCA). The safety of the procedures was evaluated by detecting early and late complications of the procedures, thus determining morbidity and mortality. Methodology A descriptive cross-sectional, quantitative and retrospective study, with quantitative and non-experimental research design, was conducted from April 2012 to October 2015 at the Oncology Gynecology Service of the Brazilian National Institute of Cancer (INCA) Patients ineligible for surgical treatment or presenting non-precocious clinical stage (ASA III and IV evaluation) were excluded from the study. After applying the exclusion criteria, 135 women diagnosed with early stage gynecological cancer (uterine cervix, endometrium, and ovary) submitted to assisted robotic surgery performed through the Da Vinci Si® platform (Sunnyvale, CA Intuitive Surgical) were selected. Variables such as age, time of surgery, mooring time, length of hospital stay, blood loss in the operative period, number of blood transfusions, the rate of surgery for open surgery and number of dissected lymph nodes were observed through the analysis of medical records. Results Of the 135 surgeries studied, there was one case of conversion to laparotomy due to an endometrial stage IV cancer and in five cases of cervical cancer, radical hysterectomies were not performed due to the presence of pelvic lymph nodes positive for malignancy. 11 (8.14%) patients with stages IIIa and IIIb by the Clavien- Dindo Classification required a new surgical intervention. A bladder perforation resulting from the use of a uterine manipulator was treated by robotic surgery but no patient had multiple organ failure or death. Érico Lustosa Ferreira¹, Julio C Nunes 2 , Mariana Zandoná 2 , Caio Perret 2 , Rossano Fiorelli 3 * and Agostinho Manuel da Silva Ascenção 3 1 Senior Staff of the Brazilian National Institute of Cancer (INCA), Brazil 2 Medical students at UNIRIO, Department of Surgery, Brazil 3 Ph.D. Professor and Advisor in the surgery post- graduation program (UNIRIO), Brazil Received: 04 April, 2019 Accepted: 23 May, 2019 Published: 24 May, 2019 *Corresponding author: Rossano Fiorelli, M.D. PhD, Hospital Universitário Gaffrée e Guinle. Departamento de Cirurgia. Rua Mariz e Barros, 775 – Rio de Janeiro, RJ, Brazil, Tel: +55 (21) 2264-4339; E-mail: https://www.peertechz.com