Conclusion
This single institution study, with one surgical team over a period of ten years, suggests the initial learning phase of robot-assisted laparoscopy in early stage cervical cancer to be at least 61 procedures, with a significant increase in disease-free survival and disease-specific survival after this initial learning phase. Overall, robot-assisted laparoscopy in patients with early stage cervical cancer shows high survival rates, comparable with observational results both historically after open surgery as well as currently in national surveys of robot-assisted surgery, when performed by an experienced surgical team. The impact of the learning curve of robot-assisted surgery on oncological outcomes warrants more attention and should be included in future studies on the safety of robot-assisted surgery.