Oncological outcomes, safety, efficacy in high BMI patients, attitude, and cost of robotic surgery for endometrial cancer management: a systematic review

Introduction: Endometrial cancer is one of the most widespread gynecological carcinomas, and its incidence is constantly increasing. Numerous non-genetic factors play a role in its development. Therefore, many patients present with major comorbidities. Robotic surgery is becoming a well-established method of endometrial cancer surgical management. It is considered especially beneficial in vulnerable populations, such as high BMI patients. Material and methods: A systematic literature search was performed in the Web of Science, PubMed, and Scopus databases. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: We screened 1135 articles altogether, with 19 studies included in the analysis. Robotic surgery is currently considered as effective and as safe as laparoscopic surgery and safer than open surgery. It correlates with fewer perioperative complications, lower blood loss, and longer operating time. Cost and public awareness remain major issues regarding robotic surgery. Therefore, educational interventions could be beneficial in raising awareness of this method of endometrial cancer management.