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Robotic-assisted ‘da Vinci’ surgery emerges as effective option for endometrial cancer patients: Study

It shows fewer complications, shorter hospital stays, less blood loss, fewer transfusions, and fewer conversions to open surgery compared to other approaches
Photo for representational purpose only. iStock

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Robotic-assisted surgery using ‘da Vinci’ technology is linked to lower complication rates, enhanced recovery, shorter hospital stay, and fewer conversions to open surgery in cancer patients, a recent study has found.

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The multicentre study published in ‘Cureus’ by the Indian Gynecologic-Onco Study Group offers one of the most comprehensive real-world assessments of endometrial cancer surgery in India.

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The findings highlight the efficiency of robotic-assisted surgery using advanced technologies like the “da Vinci” in improving surgical safety, enhancing recovery, and supporting consistent oncologic outcomes for patients.

Endometrial cancer, particularly diagnosed among women, is a cancer of the uterus that starts in the inner lining, the endometrium.

The study group constituted by Intuitive Surgical, a medical device company headquartered in United States, had surgeons from leading healthcare institutes and groups like the Rajiv Gandhi Cancer Institute and Research Centre, Tata Medical Centre, Aster, Apollo Hospitals, Narayana Health, Fortis, Amrita Institute of Medical Sciences, KDH Group and Medica.

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The study analysed more than 2,000 patients with Stage-I endometrial cancer treated across 13 Indian hospitals and compared the operative outcomes across three different approaches — open surgery, conventional laparoscopy and robotic-assisted surgery.

Among the three approaches, robotic-assisted surgery delivered the strongest advantages, the study found. It was associated with lower complication rates, along with shorter hospital stays, less blood loss, fewer transfusions, and fewer conversions to open surgery compared to laparoscopy, according to the study.

The operative time was also about 50 minutes shorter than laparoscopy and 20 minutes shorter than open surgery, which meant patients spent less time under anaesthesia and recovered from the operation theatre more quickly.

Robotic-assisted surgery showed a lower rate of positive surgical margins than laparoscopy, reducing the risk of recurrence.

A positive surgical margin indicates that cancer cells are not completely removed during the removal of any tissue, which suggests possibility of cancer recurrence.

The da Vinci surgical system’s enhanced visualisation enabled cancer clearance on par with open surgery, but with added advantages such as improved precision, quicker recovery, and less pain, the study said.

Robotics further enabled more comprehensive staging, including lymph node dissection, which is critical for assessing the disease spread and planning the treatment.

Patients who underwent robotic-assisted surgery could also start post-operative chemotherapy about a week earlier than those who had laparoscopy, and roughly four days earlier than those who had open surgery, a factor that can directly improve the long-term outcomes, the study said.

“The findings help address a long-standing gap in localised data. Until now, Indian clinicians largely relied on international studies to guide surgical decisions in gynaecologic oncology,” said Dr Vandana Jain from the Rajiv Gandhi Cancer Institute and Research Centre, New Delhi.

Dr Vandana, who is also one of the leading contributors to the study, said, “This new multicentre evidence offers a more nuanced picture of how these approaches perform in real-world Indian settings and could inform both clinical pathways and institutional adoption strategies going forward.”

The study highlights how robotic-assisted surgery can deliver safer outcomes for patients, especially for those who often face higher surgical risk such as older or obese women with additional health conditions, where minimising the complications and recovery time becomes critical.

“Robotic systems like ‘da Vinci’ offer greater access and precision, especially in narrow or anatomically challenging spaces, which makes them particularly effective. They allow us to remove the cancer tissues thoroughly while reducing the physical impact of surgery,” she said.

“With robotic-assisted procedures, we have been able to lower the complication rates and shorten hospital stays without compromising oncologic safety. These are meaningful advantages for both patients and the surgical teams working to give them the best possible care,” Dr Vandana said.

Dr Jaydip Bhaumik from the Tata Medical Centre, Kolkata, who is also a contributor to the study, said, “This kind of India-specific evidence is critical. It helps hospitals assess whether newer technologies like robotic-assisted surgery are translating into tangible benefits in our patient population.”

“It also gives the surgeons a clear reference point on where each approach stands in terms of safety, efficacy, and post-operative recovery,” he added.

As the incidence of endometrial cancer continues to rise in India, especially among pre and post-menopausal women, studies like this are timely.

It shows that for women with early-stage endometrial cancer, robotic-assisted surgery can be a safe and effective choice, offering greater precision, quicker recovery, and more reliable staging, using which surgeons can assess better the extent of the cancer for further treatment, if necessary.

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#MinimallyInvasiveSurgery#RoboticSurgeryCancerRecoveryCancerSurgeryIndiadaVinciSurgeryEarlyStageCancerEndometrialCancerGynecologicOncologyRoboticAssistedSurgeryUterineCancerTreatment
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