Evaluating postoperative pain and satisfaction among women treated by robotic surgery for gynecologic cancer

Jeremie Abitbol, Susie Lau, Agnihotram V. Ramanakumar, Nancy Drummond, Zeev Rosberger, Raphael Gotlieb, Jeffrey How, Roy Kessous, Walter H. Gotlieb


Background: Postoperative pain is frequently undermanaged in spite of advancements in pharmacologic and non-pharmacologic therapies for pain. Minimally invasive surgery is a promising surgical technique associated with reduced postoperative pain. The current study evaluates satisfaction following robotically-assisted surgery and its impact on short-term and long-term patient-rated pain.
Methods: Prospective study on all consecutive patients (n=367) undergoing robotic surgery in the division of gynecologic oncology from December 2009 to December 2012. Patients were invited to complete questionnaires before surgery and at 1 week, 3 weeks, 3, 6, and 12 months after surgery. The brief pain inventory (BPI) was used to evaluate patient-rated pain severity, interference of pain with daily life, and treatments taken for pain.
Results: After controlling for preoperative factors, both pain severity and pain interference with daily life returned to pre-surgery levels within three weeks of surgery. Patients using opioids for pain relief remained very low, varying from 2% at baseline to 11% during the first week, returning to 5% by the third week. By the first week post-surgery, the vast majority of patients expressed high satisfaction with an average score of 91%.
Conclusions: Robotic surgery for the treatment of gynecologic cancers results in a minimal impact on short- and long-term patient-rated pain. The majority of patients (~90%) did not require the use of opioids and were very satisfied with their surgery.