The learning curves of robotic and three-dimensional laparoscopic surgery in cervical cancer

BACKGROUND: The 3D laparoscopy systems and robotic systems have been introduced into clinical practice for a few years. But the comparison of robotic and 3D laparoscopic gynecologic surgery is still needed. OBJECTIVE: To retrospectively compare the learning curves of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer. STUDY DESIGN: The operational duration, blood loss, peritoneal drainage of first 24 hours after operation, total hospitalization days, hospitalization days after operation, lymph nodes collected, learning curves and cost of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer performed by one experienced surgeon were studied. RESULTS: There was one surgeon who performed 37 cases of robotic and 24 cases of 3D laparoscopic hysterectomy and pelvic lymphadenectomy, and the turning point of learning curves was case 13(th) and case 10(th). The differences of duration of operation, blood loss, peritoneal drainage of first 24 hours after operation, total hospitalization days, hospitalization days after operation, lymph nodes collected and perioperative complications were not statistically significant. But the cost of each robotic operation was higher than 3D operation. CONCLUSIONS: The turning point of the learning curve of 3D laparoscopic hysterectomy and pelvic lymphadenectomy is earlier than that of robotic sugery in patients with cervical cancer, and there is no obvious benefit from robotic surgery than 3D surgery in the terms of short-term medical index and hospitalization cost.