†These authors contributed equally.
Objective: Minimally invasive surgery is a standard treatment for endometrial cancer patients with uterine-confined disease. Robot-assisted surgery has been covered under public insurance since 2018 in Japan. The aim of the current study was to compare the short-term outcomes between robot-assisted modified radical hysterectomy (RAMRH) and total laparoscopic modified radical hysterectomy (TLMRH). Methods: A total of 190 patients with endometrial cancer who had undergone RAMRH or TLMRH were retrospectively reviewed. Short-term outcomes, including surgical time, estimated blood loss, complications, and hospital stay, were compared between the groups. Results: Among 190 patients, including 67 with RAMRH and 123 with TLMRH, the median (interquartile range [IQR]) surgical time was 247 (IQR: 221-313) min in RAMRH and 271 (IQR: 236-280) min in TLMRH. The estimated blood loss was less than 10 mL in most cases. There was 1 major vessel injury and 1 vescio-vaginal fistula in the RAMRH group. In contrast, there were 2 bladder injuries, 1 bowel injury, 2 obturator nerve injuries, 1 major vessel injury, and 2 pelvic abscesses in the TLMRH group. The median hospital stay was 10 (IQR: 10-10) days in RAMRH and 9 (IQR: 9-10) days in TLMRH. Conclusion: Robot-assisted procedures were not associated with poorer short-term outcomes than laparoscopy in patients with endometrial cancer.