Effect of Body Mass Index on Robotic-Assisted Total Laparoscopic Hysterectomy

Nawfal, A.K.; Orady, M.E.; Eisenstein, David; Wegienka, Ganesa

doi:10.1016/j.jmig.2011.01.009

Cited by 47 publications

(23 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Heinberg et al did find significant associations between obesity and blood loss greater than 500 mL [6]. Regarding robotic assisted total laparoscopic hysterectomies, other studies have not reported a correlation between BMI and blood loss, postoperative complications, operative room times, or length of stay [15,16]. Our study found that robotic hysterectomy demonstrated an increased frequency of post-operative mechanical ventilation (6.5%) compared to both open and laparoscopic surgeries; this was a novel finding.…”

Section: Discussionsupporting

confidence: 55%

Beyond mere obesity: Effect of increasing obesity classifications on hysterectomy outcomes for uterine cancer/hyperplasia

Giugale

Santo

Smolkin

et al. 2012

Gynecologic Oncology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 55%

Beyond mere obesity: Effect of increasing obesity classifications on hysterectomy outcomes for uterine cancer/hyperplasia

Giugale

Santo

Smolkin

et al. 2012

Gynecologic Oncology

View full text Add to dashboard Cite

“…14 Studies investigating the impact of obesity in benign robotic gynecologic surgeries showed no difference in perioperative outcomes or length of surgery in obese patients. [15][16][17] George et al reviewed data on 77 patients undergoing robotic myomectomies. Thirty-two patients (41.6%) were obese or morbidly obese (BMI > 30).…”

mentioning

confidence: 99%

Influence of Morbid Obesity on Surgical Outcomes in Robotic-Assisted Gynecologic Surgery

Eddib

Danakas

Hughes

et al. 2014

Journal of Gynecologic Surgery

View full text Add to dashboard Cite

Objective: The aim of this research was to estimate the impact of body mass index (BMI) on surgical outcomes in patients undergoing robotic-assisted gynecologic surgery. Materials and Methods: This study was a retrospective review of prospectively collected cohort data for a consecutive series of patients undergoing gynecologic robotic surgery in a single institution. BMI, expressed as kg/m 2 , was abstracted from the medical charts of all patients undergoing robotic hysterectomy. Data on estimated blood loss (EBL), hemoglobin (Hb) drop, procedure time, length of hospital stay, uterine weight, pain-medication use, and complications were also extracted. Results: Two hundred and eighty-one patients underwent robotic operations. Types of procedures were total hysterectomy with or without adnexal excision, and total hysterectomies with lymphadenectomies. Eighty-four patients who were classified as morbidly obese (BMI > 35) were compared with 197 patients who had a BMI of < 35 (nonmorbidly obese). For patients with BMI < 35, and BMI > 35, the mean BMI was 27.1 and 42.5 kg/m 2 ( p < 0.05), mean age was 49 and 50 ( p = 0.45), mean total operative time was 222 and 266 minutes ( p < 0.05), console time 115 and 142 minutes ( p < 0.05), closing time (from undocking until port-site fascia closure) was 30 and 41 minutes ( p < 0.05), EBL was 67 and 79 mL ( p = 0.27), Hb drop was 1.6 and 1.4 ( p = 0.28), uterine weight was 196.2 and 227 g ( p = 0.52), pain-medication use 93.7 and 111 mg of morphine ( p = 0.46), and mean length of stay was 1.42 and 1.43 days (0.9), all respectively. No statistically significant difference was noted between the 2 groups for EBL, Hb drop, LOS, uterine weight, pain-medication use, or complications. The only statistically significant difference was seen in operating times and included docking, console, closing, and procedure times. There were no perioperative mortalities. Morbidity occurred in 24 patients (8%). In the morbidly obese group, there were 6 complications (7%) and, in the nonmorbidly obese group, there were 18 complications (9%). Conclusions: Morbid obesity does not appear to be associated with an increased risk of morbidity in patients undergoing robotically assisted gynecologic surgery. Morbid obesity is associated with increased procedure time, but otherwise appears to have no difference in outcomes. Robotic surgery offered an ideal approach, allowing minimally invasive surgery in these technically challenging patients, with no significant increase in morbidity. J GYNECOL SURG 30:81)

show abstract

“…Laparoscopic route for overweight patients although poses operative difficulties, is a better option as it gives better operative vision and almost negates wound dehiscence which they are at risk. [12][13][14][15][16] Length of surgery was slightly longer than our vaginal and abdominal procedures. There is a variation in the length of surgery for laparoscopic procedures quoted by other studies and some of the reasons are operator experience, uterine size and BMI.…”

Section: Discussionmentioning

confidence: 99%