Robotic surgical staging for obese patients with endometrial cancer

Robotic surgery in supermorbidly obese patients with endometrial cancer

“…However, most published reports that evaluate the safety and feasibility of robotic surgical management of endometrial cancer do not include the supermorbidly obese patient population (Table 5). 17,[20][21][22][25][26][27][28][29][30][31][32] In fact, despite the known benefits of robotic surgery, there has been a hesitancy to use this approach in supermorbidly obese patients, because of both patient physiologic limitations and a fear of operative conversion because of technical challenges or anesthesia complications. In this study, none of the conversions to laparotomy were due to inability of the patients to tolerate even the steepest possible Trendelenburg positioning, regardless of the degree of obesity.…”

Robotic Single-Site Surgery in Management of Obese Patients With Early-Stage Endometrial Cancer

“…Moreover, numerous obesityrelated comorbidities, such as cardiovascular, metabolic, and respiratory diseases, are responsible for the anesthesiologic limitations to surgery [3,4].…”

“…Indeed, laparoscopy is able to ameliorate surgical vision, reduce tissue trauma, and decrease postsurgical infection. The more rapid mobilization after laparoscopy can reduce the risk of thromboembolism in this subsets of high-risk patients [4][5][6].…”

The roles and limitations of robotic surgery for obese endometrial cancer patients: a common challenge in gynecologic oncology

“…Tang et al [10] also compared robotics to laparotomy with a mean BMI in both groups that was above 39. Conversion was commonly related to poor exposure due to visceral adiposity or adhesions.…”

“…More importantly, the magnified view afforded by robotic surgery, though allowing for higher resolution of the cuff, may lead surgeons to take less tissue while suturing than typically done in laparotomy. Tang et al [10] reported increased vaginal cuff complications in the robotic arm, with six total patients developing cellulitis, seromas, hematomas, and dehiscence, respectively. In another review, Menderes et al [15] reported cuff dehiscence as 0.8 %.…”