Robotic Hysterectomy Strategies in the Morbidly Obese Patient

Almeida, Oscar D.

doi:10.4293/108680813x13693422521511

Cited by 24 publications

(9 citation statements)

References 16 publications

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“…Obesity, which has become an epidemic in developed countries, does not appear to be associated with a higher risk of morbidity in patients undergoing robotic‐assisted gynaecologic surgery 9–11 . Extreme obesity, expressed as a body mass index (BMI) ≥ 40 kg/m 2 , has increased more than four‐fold since the mid‐1980s and is now a major public health problem 12 .…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Gitas

Alkatout

Proppe

et al. 2021

Robotics Computer Surgery

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Introduction The aim of the present study was to compare surgical outcomes of total laparoscopic hysterectomy with those of the robotic approach using the da Vinci Xi system. Methods Patients who underwent hysterectomy with da Vinci Xi for early endometrial cancer or benign indications from 2018 to 2019 were selected. The control group consisted of patients who underwent conventional laparoscopy. Results A total of 300 patients were included in the study. The mean duration of surgery differed significantly (p = 0.025) between those who underwent laparoscopy (125.01 ± 76.168) and robotic‐assisted surgery (142.96 ± 82.657 min). Blood loss, median hospital stay, intraoperative and postoperative complications were similar in both groups. No statistical difference was observed in the subgroups with a body mass index of more than 30 kg/m2 or more than 40 kg/m2 concerning the duration of surgery or the surgical outcome. Conclusion The da Vinci Xi did not improve surgical outcomes in patients who underwent hysterectomy by trained laparoscopists and takes more time than conventional laparoscopy when performed in patients of normal weight.

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Section: Introductionmentioning

confidence: 99%

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Gitas

Alkatout

Proppe

et al. 2021

Robotics Computer Surgery

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“…16,17 However, there have been few reports that have examined the use of robotic surgery for endometrial cancer staging in the supermorbidly obese patients (BMI, 50 kg/m 2 ), and most of these used a BMI of 40 kg/m 2 as a cutoff. [18][19][20][21][22] We examined the safety and feasibility of robotic surgery for endometrial cancer in supermorbidly obese patients and compared their outcomes with the outcomes of patients with lower body mass indices.…”

mentioning

confidence: 99%

Robotic surgery in supermorbidly obese patients with endometrial cancer

Stephan¹,

Goodheart²,

McDonald³

et al. 2015

American Journal of Obstetrics and Gynecology

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“…It is in line with the literature confirming that robotic surgery is a preferable route for obese patients undergoing hysterectomy. 11 , 37 In our series, no significant statistical difference was noted in terms of complications, LOS, and conversions between the obese and nonobese groups. There was, however, a statistically significant increase in estimated blood loss in the group with BMI > 30 compared to the group with BMI ≤ 30.…”

Section: Discussionmentioning

confidence: 46%

Robotic Hysterectomy for Benign Indications: What Have We Learned from a Decade?

Carbonnel¹,

Moawad²,

Tarazi³

et al. 2021

JSLS

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Background and Objectives: Robotic surgery data need a setback on many years of practice with high-volume surgeons to evaluate its real value. Our main objective was to study the impact of a decade of robotic surgery on minimally-invasive hysterectomies for benign indications. Our secondary objectives were to evaluate our results for high-volume surgeons and complex cases. Methods: In this retrospective cohort study, we reviewed medical records at Foch Hospital, from 2010 to 2019, to evaluate the outcomes of robotic hysterectomies for benign disease. We compared the trends of benign hysterectomies done by laparoscopy and laparotomy during this period. We analyzed the proficiency group (≥ 75 cases per surgeon) and complex cases including obese patients and large uteri (>250 g). Results: 495 hysterectomies were performed by robotic, 275 by laparotomy, and 130 by laparoscopy. The laparotomy approach decreased from 62% to 29%, whereas the robotic approach increased from 26% to 61%. The operating room (OR) time decreased in the proficiency group (157.3 ± 43.32 versus 178.6 ± 48.05, P = 0.005); whereas the uterine weight was higher (194.6 ± 158.6 versus 161.3 ± 139.4, P = 0.04). Lower EBL and shorter OR time were seen with uteri ≤ 250 g subgroup (64.24 ± 110.2 ml versus 116.63 ± 146.98 ml, P = 0.0004) (169.62 ± 47.50 min versus 192.44 ± 45.82 min, P = 0.0001). The estimated blood loss (EBL) was less in the BMI ≤ 30 subgroup (68.83 ± 119.24 ml versus 124.53 ± 186.14 ml, P = 0.0005). Conclusion: A shift was observed between the laparotomy and robotic approaches. High-volume surgeons were more efficient and showed a decrease in OR time after 75 cases despite an increase in uterine weight.

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Robotic Hysterectomy Strategies in the Morbidly Obese Patient

Abstract: Strategies to improve the success of robotic hysterectomy in the morbidly obese patient are reviewed in this study.

Cited by 24 publications

References 16 publications

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Robotic surgery in supermorbidly obese patients with endometrial cancer

Robotic Hysterectomy for Benign Indications: What Have We Learned from a Decade?

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