Outcomes of Robotic-Assisted Laparoscopic Hysterectomy Stratified by Body Mass Index

Background and Objectives. To describe a novel technique for a port-reducing laparoscopic hysterectomy. The 2-port laparoscopic hysterectomy (TPH) is performed through two 5-mm ports without the use of any multiport channels. We demonstrate outcomes via a large case series. We also describe and provide a video showing the TPH technique. Methods. Retrospective comparative study between the newly developed TPH and the conventional 4-port hysterectomy techniques. Variables of patients who underwent a TPH with fellowship-trained gynecologic surgeons at a single academic university hospital were collected through electronic medical records chart review. Results. Forty-five patients underwent a TPH. Mean age was 39.4, body mass index was 28.5 kg/m2, and uterine weight was 170.0 g. Our outcomes of interest were operative time (98.4 minutes, mean), estimated blood loss (65.6 mL, mean), conversion to 3-port (1/45), and intraoperative (0/45) and postoperative (5/45) complications. By comparing the TPH to the conventional 4-port laparoscopic hysterectomy within a similar setting, we provide insight into variables that prompt the minimally invasive gynecologic surgeon to perform a port-reducing procedure. Patients were more likely to be allocated for a TPH if they were younger (37.8 vs 44.7, P = .005), had a lower body mass index (29.0 vs 32.5, P = .07), smaller uterus (143.1 vs 672.3 g, P < .001), and were white (56.8% and 22.4%, P < .001). Conclusions. The TPH is a novel port-reducing hysterectomy that is safe in a subset of patients with small uteri and limited surgical history who require no other surgical interventions at the time of hysterectomy.

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Body Mass Index and Its Role in Total Laparoscopic Hysterectomy

International Scholarly Research Notices ◽

10.1155/2014/787604 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Shilpa Bhandari ◽

Pallavi Agrawal ◽

Aparna Singh

Keyword(s):

Body Mass Index ◽

Blood Loss ◽

Body Mass ◽

Operative Time ◽

Intraoperative Complications ◽

Laparoscopic Hysterectomy ◽

Total Laparoscopic Hysterectomy ◽

Perioperative Outcomes ◽

Obese Patients ◽

Duration Of Surgery

Objective. To evaluate operative and perioperative outcomes in patients undergoing total laparoscopic hysterectomy according to their body mass index. Method. A retrospective study was performed for patients undergoing total laparoscopic hysterectomy at a tertiary care center for a period of 4 years. Patients were divided into two groups: obese (BMI > 30 Kg/m2) and nonobese (BMI < 30 Kg/m2). Duration of surgery, intraoperative blood loss, successful laparoscopic completion, and intraoperative complications were compared in two groups. Result. A total of 253 patients underwent total laparoscopic hysterectomy from January 2010 to December 2013. Out of them, 105 women (41.5%) had a BMI of more than 30 kg/m2. Overall, the mean blood loss was 85.79 ± 54.17 mL; the operative time was 54.17 ± 19.83 min. The surgery was completed laparoscopically in 244 (96.4%) women while laparotomy was done in 4 cases and vaginal suturing and closure of vault were done in 5 cases. Risk of vaginal assistance was higher in obese patients whereas out of the 4 conversions to laparotomy 3 had BMI < 30 kg/m2. The operative time was increased as the BMI of patient increased. Conclusions. Total laparoscopic hysterectomy is a safe and effective procedure for obese patients and can be performed with an efficacy similar to that in nonobese patients.

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The impact of the body mass index (BMI) on laparoscopic hysterectomy for benign disease

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-013-3050-2 ◽

2013 ◽

Vol 289 (4) ◽

pp. 803-807 ◽

Cited By ~ 14

Author(s):

David Bardens ◽

Erich Solomayer ◽

Sascha Baum ◽

Julia Radosa ◽

Stefan Gräber ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Laparoscopic Hysterectomy ◽

Benign Disease ◽

The Body ◽

The Impact

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A Comparative Study of the Influence of Body Mass Index on Clinical Outcomes of Total Laparoscopic Hysterectomy in Birat Medical College Teaching Hospital, Morang, Nepal

Birat Journal of Health Sciences ◽

10.3126/bjhs.v6i1.37642 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1383-1387

Author(s):

Bhanubhakta Neupane ◽

Gyanendra Man Singh Karki ◽

Hanoon P Pokharel ◽

Prerana Dahal ◽

Garima Bhandari

Keyword(s):

Body Mass Index ◽

Postoperative Complications ◽

Body Mass ◽

Teaching Hospital ◽

College Teaching ◽

Laparoscopic Hysterectomy ◽

Total Laparoscopic Hysterectomy ◽

Medical College ◽

Increased Risk ◽

High Bmi

Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult. Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy. Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups. Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy.

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