Salvage Radical Hysterectomy for Recurrent Cervical Cancer in a Previously Irradiated Field Using the hinotori™ Surgical Robot System: A Case Report

Salvage radical hysterectomy for recurrent cervical cancer within a previously irradiated field is technically demanding due to radiation-induced fibrosis and adhesions. Robot-assisted surgery may offer advantages over open surgery, including enhanced three-dimensional visualization, improved ergonomics, and tremor filtration, potentially enabling safer and more precise dissection in fibrotic tissue planes. However, to date, evidence in the recurrent setting remains limited and has been reported exclusively with the da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, California, United States). In this report, we describe a case of salvage radical hysterectomy performed with the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan) in a 60-year-old woman with locally recurrent cervical cancer in a previously irradiated field. Despite the technical difficulties associated with operating in a previously irradiated field with radiation-related fibrosis, the recurrent cervical tumor was completely resected without intraoperative or postoperative complications. This case demonstrates the potential feasibility and safety of hinotori-assisted salvage radical hysterectomy for complex procedures in irradiated fields and warrants further evaluation in larger series.