Obesity and perioperative pulmonary complications in robotic gynecologic surgery

Perioperative pulmonary complications in obese patients undergoing robotic procedures for gynecological cancers

“…TO THE EDITORS: With a great deal of interest we read the recent article in your journal entitled, "Obesity and perioperative pulmonary complications in robotic gynecologic surgery." 1 We agree with the authors of this fine paper that the vast majority of obese patients can successfully tolerate robotic procedures and the finding is very interesting that only 3% could have a pulmonary complication: eg, oxygen saturation (SpO2) <90%, delayed extubation or reintubation, pulmonary edema or pleural effusion, infection, inadequate tidal volume (TV), pulmonary embolus, and bronchospasm.…”

“…We appreciate the opportunity to address the questions raised by Iavazzo et al regarding our recently published study entitled "Obesity and perioperative pulmonary complications in robotic gynecologic surgery." 1 As Iavazzo et al stated, there is significant comorbidity between some types of gynecologic cancer and obesity, with 70-90% of patients with type I endometrial cancer also meeting criteria for obesity. 2 We agree that patients undergoing robotic gynecologic surgery for treatment of oncologic conditions may spend more time in Trendelenburg position and may have longer operative times than patients undergoing robotic gynecologic surgery for benign indications.…”

Utilization of Minimally Invasive Surgery in Endometrial Cancer Care

“…By considering a 50% increase in minimally utilization nationally for a variety of surgical procedures, this would potentially result in 3,578 fewer complications, 144,853 fewer hospital days, and $288 million in savings annually. 23 Because most women with endometrial cancer are obese and possess comorbidities, 24,30 this cohort is at a particularly high risk of perioperative morbidity and would be among the populations most likely to benefit from a nationwide effort to reduce complications and health care costs with better utilization of minimally invasive surgery.…”

“…[8][9][10][11] The current variation in practice patterns identified in our study of the Nationwide Inpatient Sample brings new attention on minimally invasive surgery as an intervention to improve quality and safety in health care. 13,[23][24][25][26][27][28][29] Data from our study suggest that fewer than half of 32,560 patients with nonmetastatic endometrial cancer underwent minimally invasive hysterectomy during a contemporary treatment period.…”

Obesity and gynecologic surgery via minimally invasive surgery with comparison to open laparotomy; a case report and review of the literature

“…1 Concerns about patient positioning and optimal visualization during surgery lead to laparotomy in many obese patients. 2 However, despite the adverse associated effects of obesity on the cardiovascular and respiratory systems, minimally invasive techniques may still be preferable over laparotomy to minimize postoperative complications in patients with compromised health status.…”