Main findings
A large number of patients achieved robotic-assisted MDT gynaecological
surgeries have undergone at least one abdominal or gynaecological
surgery before. The mean hospital stay reached to 23 days and the mean
medical expense was about 93,605 yuan. Age, BMI value, medical
complications (such as hypertension and diabetes) and the characteristic
of gynaecological diseases seemed to have no relationship with whether
to organize an MDT surgery.
It was investigated that mean MDT operation time was 285.85 min. At
least half of the patients in our study had a blood loss volume of no
more than 200 ml, while they didn’t require blood transfusions. General
surgeons and urological surgeons appeared in most cases. Follow-up
chemotherapy and radiotherapy were the common reasons for patients who
had a 30-day readmission. Only two cases came back for complication, and
one of them adopted intervention.
According to the description in the surgical record, we summarized 6
main reasons for robotic-assisted MDT gynaecological surgeries above.
Indication of the surgeries was based on the above conclusions.
Obviously, when aggressive diseases invaded to other non-gynaecological
organs, it was a good choice to organize a robotic-assisted MDT
gynaecological surgery to accomplish the metastasis resection and avoid
complications. Other indications consisted of intraoperative assistance
for judging the metastasis, separating adhesions, and solving unexpected
complications (ureteral and bladder injury, intestinal damage, vascular
damage and so on). In addition, a robotic-assisted MDT gynaecological
surgery could be used to cure complex gynaecological and
non-gynaecological diseases at the same time. In fact, dealing with
complications following with the last surgery was not an indispensable
indication for robotic-assisted MDT gynaecological surgeries in our
comments. There was no significant difference in the surgical skills
between simple gynaecological robotic surgeries and robotic-assisted MDT
gynaecological surgeries. What we need to focus on during the surgery
was that pelvic anatomy should be distinguished clearly and vice-damage
should be avoided.
After the robotic-assisted MDT gynaecological surgeries, surgeons must
pay more attention on postoperative infection. It was reported in our
research that up to 23.08% of the patients had different degrees of
infection after surgery, most of whom suffered from multi-site
infection.