Feasibility and Outcomes of a Robotic Retroperitoneal Approach to Para‐Aortic Lymphadenectomy in Intermediate‐ and High‐Risk Endometrial Cancer: A Prospective Study

Background This prospective feasibility study evaluated the safety and efficacy of robotic retroperitoneal para‐aortic lymphadenectomy in patients with intermediate‐to high‐risk endometrial cancer. Methods Patients with endometrial cancer who underwent robotic surgical staging at Mie University Hospital between October 2021 and May 2025 were prospectively enroled and analysed following ethics approval. Patient clinical data, intraoperative parameters, and postoperative quality of life (QOL) were collected according to a predefined protocol. Results The study included 18 patients with a median operative time of 411.0 min, median blood loss of 51.0 mL, and 25.5 and 24.5 resected pelvic and para‐aortic lymph nodes, respectively. Para‐aortic lymph node metastasis was observed in one case, and postoperative complications in two. QOL returned to baseline within 28 days postoperatively. Conclusions The robotic retroperitoneal approach to para‐aortic lymphadenectomy is a feasible and safe staging procedure for intermediate‐to high‐risk endometrial cancer, with rapid postoperative QOL recovery. Trial Registration This study was registered in the Japan Registry of Clinical Trials (jRCT1042210047).