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.