Medico-economic Evaluation of Robot-assisted Laparoscopy Compared With Conventional Laparoscopy in Hysterectomy for Endometrial Cancer.

Randomized Study:

Inclusion Criteria:

• Patient with low-risk or intermediate-risk endometrial carcinoma (on pre-operative workup including histology on endometrial biopsy and pelvic and lumbo-aortic MRI) , i.e. patients with endometrioid-type endometrial adenocarcinoma cancer low-grade (grade 1 or 2) and pre-therapeutic FIGO stage I (FIGO classification 2023) on MRI.

• Indication for minimally invasive STH (laparoscopy) given by the surgeon during the pre-op consultation.

• Patient accepts the matching of pseudonymized data with the French National Health Data System (SNDS) Major patient.

• Patient having received information on the protocol and having signed a consent form, thus accepting randomization in the robot-assisted intervention group versus conventional laparoscopy.

Non Inclusion Criteria:

• Patient operated on by a surgeon with less than 30 cases of robotic surgery in the last year and/or with less than 50 cases of total robotic experience at the time of patient inclusion.

• Patient refuses to participate in randomized controlled trial (refuses randomization)

• The surgeon refuses the patient's participation in the randomized controlled trial (does not wish to randomize the patient).

The center does not have a robot The center does not have a laparoscopic column with fluorescence

• Person under legal protection (safeguard of justice, curatorship, guardianship) or person deprived of liberty;

• Patient not affiliated to a French social security scheme

• Patient participating in a non-observational trial

• Pregnant or breast-feeding patient

Exclusion criteria :

• Minimally invasive procedure contraindicated by pre-operative anesthesia.

• Patient operated on by a robot other than one of the intuitive robot variants (Si, X and Xi).

Prospective cohort:

Inclusion Criteria:

• Patient with low-risk or intermediate-risk endometrial carcinoma (on pre-operative workup including histology on endometrial biopsy and pelvic and lumbo-aortic MRI) , i.e. patient with endometrioid-type endometrial adenocarcinoma cancer low-grade (grade 1 or 2) and pre-therapeutic FIGO stage I (FIGO classification 2023) on MRI .

• Indication for minimally invasive STH (laparoscopy) given by the surgeon during the pre-op consultation.

• Patient accepts the matching of pseudonymized data with the French National Health Data System (SNDS)

• Major patient.

• Patient not included in randomized controlled trial because :

• Patient refuses to participate in randomized controlled trial (refusing randomization)

• The surgeon refuses the patient's participation in the randomized controlled trial (does not wish to randomize the patient)

• The center does not have a robot

• The center does not have a laparoscopic column with fluorescence

• The surgeon does not meet the required learning curve criteria (as a reminder: ≥ 30 cases of robotic surgery in the last year and with total robotic experience ≥ 50 procedures ) at the time of patient inclusion

• Patient has been informed about the protocol and has signed a consent form.

Non Inclusion Criteria:

• Person under legal protection (safeguard of justice, curatorship, guardianship) or person deprived of liberty;

• Patient not affiliated to a French social security scheme

• Patient participating in a non-observational trial

• Pregnant or breast-feeding patient

Exclusion criteria :

• Minimally invasive procedure contraindicated by pre-operative anesthesia.

• Patient operated on by a robot other than one of the intuitive robot variants (Si, X and Xi).

Retrospective cohort:

Inclusion Criteria:

• Patient with low-risk or intermediate-risk endometrial carcinoma (on pre-operative workup including histology on endometrial biopsy and pelvic and lumbo-aortic MRI) , i.e. patient with endometrioid-type endometrial adenocarcinoma cancer low-grade (grade 1 or 2) and pre-therapeutic FIGO stage I (FIGO classification 2023) on MRI).

• STH performed during the inclusion period of the randomized controlled trial at a participating center, regardless of the approach used, not included in the randomized controlled trial or in the prospective cohort.

• Patient not objecting to the collection and use of her data

• Patient of legal age.

Non Inclusion Criteria:

• Person under legal protection (safeguard of justice, curatorship, guardianship) or person deprived of liberty;

• Patient not affiliated to a French social security scheme

Surgeons :

Inclusion Criteria:

• Surgeon performing hysterectomy on patients included in the randomized study and/or prospective cohort

• Surgeon not objecting to the collection and use of his data

Non- inclusion Criteria:

None