Disclosures: Dr. Kim said she had no conflicts of interest to disclose.
KISSIMMEE, FLA. — Robotic-assisted laparoscopic hysterectomy appears to be feasible and safe in morbidly obese women, with intraoperative and postoperative surgical outcomes similar to those seen in women with a lower body mass index, according to Dr. Jin Hee Kim.
At the annual meeting of the AAGL, she said, “Given these findings, we feel [that] robotic-assisted laparoscopy may play a role in decreasing the technical difficulties encountered in laparoscopic surgery, especially in overweight women.” Dr. Kim presented the results of a retrospective cohort study she performed with her colleagues at the University of Michigan, Ann Arbor. Since then, she has moved to Columbia University, New York.
The study group included 157 consecutive patients who underwent robotic-assisted laparoscopic hysterectomy at a single center from 2002 to 2009. All surgical indications were benign, including fibroids, endometriosis, pain, and abnormal bleeding. The patients were divided into two groups—those with a body mass index of less than 35 kg/m
The only significant surgical difference was operative time, Dr. Kim said. Women in the higher-weight group had a mean operative time of 214 minutes, compared with 189 minutes in the lower-weight group.
Mean blood loss was 97 mL in the higher-weight group and 72 mL in the lower-weight group, not significantly different. There was no intraoperative organ/vascular injury in the higher-weight group, while two such injuries occurred in the lower-weight group; again, this was not a significant difference. There were no significant differences in conversion to open surgery, postoperative vaginal cuff complications, and unplanned readmission within 60 days, reoperation, or length of hospital stay.
“Although women with a BMI of 35 kg/m