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Cancers in a Tertiary Center  \nDavid Knigin 1,2, Yoav Brezinov 2, Shannon Salvador 1,2, Susie Lau 1,2 and Walter H. Gotlieb 1,2, *  \nCitation: Knigin, D.; Brezinov, Y.; Salvador, S.; Lau, S.; Gotlieb, W.H. Surgery Advances in Gynecologic Tumors: The Evolution and Outcomes of Robotic Surgery for Gynecologic Cancers in a Tertiary Center. Curr. Oncol. 2024, 31, 2400–2409. [https://](https://)[ ](https://)[doi.org/10.3390/curroncol31050179](doi.org/10.3390/curroncol31050179)  \nReceived: 22 February 2024  \nRevised: 16 April 2024  \nAccepted: 23 April 2024  \nPublished: 24 April 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada; [david.knigin@mcgill.ca](david.knigin@mcgill.ca) (D.K.); [shannon.salvador@mcgill.ca](shannon.salvador@mcgill.ca) (S.S.); [susie.lau@mcgill.ca](susie.lau@mcgill.ca) (S.L.)  \n2 Segal Cancer Center, Sir Mortimer B. Davis Institute of Medical Research, McGill University, Montreal, QC H3T 1E2, Canada  \n* [Correspondence: walter.gotlieb@mcgill.ca](Correspondence: walter.gotlieb@mcgill.ca); Tel.: +1-514-340-8222 (ext. 23144); Fax: +1-514-340-8619  \nAbstract: The integration of innovation into routine clinical practice is faced with many challenges. In 2007, we received the mandate to evaluate how the introduction of a robotic program in gynecologic oncology affected patient-centered care by studying its impact on clinical outcomes and hospital resource utilization. Here we summarize the history and experience of developing a robotic surgery program for gynecologic cancers over 16 years. Analysis of the data indicates that robotic surgery improved perioperative patient clinical parameters, decreased blood loss, complications, and hospital stay, maintained the oncologic outcome, and is cost-effective, resulting in it becoming the dominant surgical approach in gynecologic oncology in a tertiary cancer care institution.  \nKeywords: robotic surgery; cost-effective; gynecologic oncology; innovation  \n1. Introduction  \nIn this review on robotic surgery for gynecologic cancers, we will address the evolution faced in the development of a robotic program in gynecologic oncology (gyn-onc) at a tertiary cancer center. The introduction of the robot at the hospital in 2007 created major controversy associated with significant resistance of many members of the departments of surgery and anesthesia. As a result, we received the mandate from the CEO to assess the value and outcomes of performing surgery using the novel robotic platform. Robotics was approved by the FDA for gynecologic surgery in 2005, but there was little experience with the platform to treat gynecologic cancers. There was a strong feeling amongst many of our colleagues, both at the hospital and in our community, that this was an expensive way of performing surgery, not relevant, and not necessary. We took up the challenges and focused on data, both clinical and financial, in order to evaluate the value of robotics. We started by evaluating perioperative outcomes by comparing the cohort of patients immediately before and immediately after the introduction of the robotic platform. Once the data confirmed perioperative improvement, we went on to evaluate the outcomes in the patients at highest risk for surgery, followed by the financial implications, and as soon as survival data became available, we showed that patients who underwent robotic surgery had an overall survival at least as good as the population undergoing a mix of laparoscopy a","cbCaicOukxDu1Gkn","https://ap.wps.com/l/cbCaicOukxDu1Gkn","pdf",507173,"English","# Introduction\n# Endometrial Cancer","[{\"question\":\"When was the robotic surgery program introduced, and what mandate initiated the evaluation?\",\"answer\":\"The program began in 2007 with a mandate to evaluate how the robotic platform affected patient-centered care by studying clinical outcomes and hospital resource utilization.\"},{\"question\":\"What perioperative benefits were reported after adopting robotic surgery?\",\"answer\":\"Robotic surgery improved perioperative clinical parameters and decreased blood loss, complications, and hospital stay while maintaining oncologic outcomes.\"},{\"question\":\"How did the program adoption affect surgical approach rates for endometrial cancer?\",\"answer\":\"For endometrial cancer, the center rapidly switched to minimally invasive surgery, offering robotic surgery to about 2/3 of patients within one year and over 90% within two years, approaching near-universal use for eligible patients.\"}]","Surgery Advances in Gynecologic Tumors - The Evolution and Outcomes of Robotic Surgery for Gynecologic Cancers in a Tertiary Center | PDF",1790020547,25]