# Feasibility and Outcomes of a Robotic Retroperitoneal Approach to Para‐Aortic Lymphadenectomy in Intermediate‐ and High‐Risk Endometrial Cancer: A Prospective Study

## TL;DR

This study shows that a robotic surgical approach for lymph node removal in high-risk endometrial cancer is safe and effective with quick recovery.

## Contribution

The study introduces a robotic retroperitoneal approach for para-aortic lymphadenectomy in endometrial cancer staging.

## Key findings

- Median operative time was 411 minutes with minimal blood loss and few complications.
- Quality of life returned to baseline within 28 days post-surgery.
- One case of para-aortic lymph node metastasis was identified.

## Abstract

This prospective feasibility study evaluated the safety and efficacy of robotic retroperitoneal para‐aortic lymphadenectomy in patients with intermediate‐to high‐risk endometrial cancer.

Patients with endometrial cancer who underwent robotic surgical staging at Mie University Hospital between October 2021 and May 2025 were prospectively enroled and analysed following ethics approval. Patient clinical data, intraoperative parameters, and postoperative quality of life (QOL) were collected according to a predefined protocol.

The study included 18 patients with a median operative time of 411.0 min, median blood loss of 51.0 mL, and 25.5 and 24.5 resected pelvic and para‐aortic lymph nodes, respectively. Para‐aortic lymph node metastasis was observed in one case, and postoperative complications in two. QOL returned to baseline within 28 days postoperatively.

The robotic retroperitoneal approach to para‐aortic lymphadenectomy is a feasible and safe staging procedure for intermediate‐to high‐risk endometrial cancer, with rapid postoperative QOL recovery.

This study was registered in the Japan Registry of Clinical Trials (jRCT1042210047).