Features of detection of sentinel lymph nodes by laparoscopic and robot-assisted approach in patients with early endometrial cancer

The increasing number of endometrial cancer patients undergoing sentinel lymph node biopsy (SLNB) and the increasing proportion of robotic-assisted surgeries necessitate an assessment of their characteristics in comparison with laparoscopic access. At the time of publication only 3 studies worldwide have evaluated the characteristics of SLNB using these approaches. Objective. To compare the results of SLNB using laparoscopic and robot-assisted approaches. Material and methods. A single-center retrospective study was conducted, including 155 patients diagnosed with early endometrial cancer. Depending on the surgical approach, the cases were divided into two groups: the robotic-assisted hysterectomy (RAH) group included 61 patients, and the laparoscopic hysterectomy (LH) group included 94 patients. The following parameters were assessed: SLN detection rates, operation time, blood loss, number of intra- and postoperative complications, and the number of empty nodal packets on final pathology. Results. The study found no significant differences between the surgical approaches regarding sentinel lymph node detection (69% and 26% for robot-assisted and 70.2% and 18.1% for laparoscopic surgeries, respectively). However, the mean operation time was significantly longer for RAH compared to LH. Conclusion. RAH and LH have comparable efficacy in performing sentinel lymph node biopsy based on key surgical indicators. The key disadvantage of RAH is a significant increase in operation time. A trend towards reduced false SLN detection, leading to the dissection of “empty” lymph node packets, was noted in the RAH group.