"Women undergoing surgery for endometrial cancer can confidently opt for a minimally invasive hysterectomy performed by a skilled surgeon  with or without a robots help  suggests a new review of surgical outcomes.  The researchers found that the two advanced minimally invasive techniques led to similar results and both appeared to be generally superior to the traditional open procedure.  With minimally invasive surgery by an experienced surgeons hands the incisions are smaller pain and suffering is less visualization is better and recovery is faster than with open surgery Dr. Ceana Nezhat of the Emory University School of Medicine in Atlanta who was not involved in the review told Reuters Health.  Robotics makes it easier for surgeons to transition from open to minimally invasive procedures he added.  More than  women are diagnosed with endometrial cancer in the U.S. every year. Treatment usually involves surgical removal of the uterus known as hysterectomy. At the same time lymph nodes are often removed to determine the stage of the cancer and whether further treatment is necessary.  The research team from the Florida Hospital Cancer Institute in Orlando reviewed eight prior studies including nearly  patients who underwent either an open closed or robotassisted hysterectomy and lymph node removal.  In the open surgery a relatively large incision is made in the abdominal wall. The closed procedure known as laparoscopy requires a much smaller cut through which small instruments and a video camera are inserted. However this minimally invasive approach also calls for significant training on the part of the surgeon to overcome challenges such as the counterintuitive movements involved in working from images on a TV monitor.  Roboticassisted surgery is similar to laparoscopy only the instruments and cameras are integrated into robotic arms which the surgeon operates through a control console. The robotic equipment provides better threedimensional vision increased range of motion and intuitive downscaled movements while adding a few thousand more dollars to the procedures price tag the authors note.  Also with the computerenhanced robotic technology no matter how much coffee you drink in the morning your movements dont have tremors said Nezhat.  Based on their review the researchers found that minimally invasive surgeries done with a human hand and instruments or with robotic assistance equipment took around the same time and resulted in similarly long stays in the hospital. However about half as much blood was lost when robots were enlisted than with standard laparoscopy.  Both minimally invasive techniques resulted in longerduration operations than open surgery. But both also led to shorter hospital stays and in the case of robotic surgery less bloodloss.  Sponsored Further the average number of lymph nodes removed was about the same in the robotic and open procedures suggesting that both approaches result in about equal surgeon accuracy in staging endometrial cancer.  No differences between the three methods were seen in the numbers of complications report the researchers in the journal Obstetrics  Gynecology.  The robot will not really decrease human errors but it will make the surgery easier Dr. Tommaso Falcone of the Cleveland Clinic in Ohio who was also not involved in the study told Reuters Health in an email.  Robotics increases the chance that a hysterectomy can be done by laparoscopy he added. However if the surgeon is skilled enough to do the hysterectomy without the robot by laparoscopy then the outcomes will be similar.  Nezhat further noted that while robotic assistance can be a good enabler for a minimally invasive approach surgeons should have at least the basic knowledge of regular laparoscopy too as there may be times when the robotic equipment doesnt work.  The reviewers point out that some of the differences found such as the longer operation times for roboticassisted surgery may be due to surgeons inexperience with the new tool and could improve over time.  On the other hand the newness of the technology could have deterred surgeons from using it for difficult cases potentially biasing the results in a positive way for the robotic technique.  Robotic surgery equipment only received U.S. Food and Drug Administration approval in . More research is needed to be able to compare longterm outcomes wrote the researchers.  Nezhat advises women to look for a surgeon experienced in doing minimally invasive surgery. If a robot is to be enlisted he recommends asking how the procedure would be performed if the robot is not available or if it doesnt work.  Roboticassisted surgery is in its infancy and it definitely has a future said Nezhat. Its benefits should offset its higher costs.  SOURCE link.reuters.comkefq httplink.reuters.comkefq Obstetrics  Gynecology December . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"