Robotic-assisted laparoscopic radical hysterectomy (Piver type III) with pelvic node dissection--case report.

OBJECTIVE: The aim of this study was to describe the first robotic-assisted radical hysterectomy (Piver type III) and bilateral pelvic lymph node dissection for a patient with Stage Ib1 cervical carcinoma. CASE: A 43-year-old woman G1, P1, previously operated on due to endometriosis with removal of the left ovary and fallopian tube, came under our care. In addition, hysteroscopic myomectomy had been done two years before. Otherwise the patient was healthy. Preoperative conization histology revealed 6 mm of stromal infiltration. The patient was offered the da Vinci robotic Wertheim operation for the first time which was well accepted and she was discharged uneventfully on the 4th day postoperatively. Four months later at a routine check-up we found asymptomatic bilateral lymphocysts but otherwise normal status.
CONCLUSION: It is fully possible to perform Piver type III laparoscopic radical hysterectomy using the da Vinci robotic system and it seems that radical dissection is much more precise than the conventional laparoscopic radical hysterectomy.