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. 2013 Jul-Sep;17(3):418-22.
doi: 10.4293/108680813X13693422521511.

Robotic hysterectomy strategies in the morbidly obese patient

Oscar D Almeida Jr  1
Affiliations

Robotic hysterectomy strategies in the morbidly obese patient

Oscar D Almeida Jr. JSLS. 2013 Jul-Sep.

Abstract

Background and objectives: The purpose of this study was to present strategies for performing computer-enhanced telesurgery in the morbidly obese patient.

Methods: This was a prospective, institutional review board-approved, descriptive feasibility study (Canadian Task Force classification II-2) conducted at a university-affiliated hospital. Twelve class III morbidly obese women with a body mass index of 40 kg/m(2) or greater were selected to undergo robotic-assisted total laparoscopic hysterectomy. Robotic-assisted total laparoscopic hysterectomy, classified as type IVE, with complete detachment of the cardinal-uterosacral ligament complex, unilateral or bilateral, with entry into the vagina was performed.

Results: The median estimated blood loss was 146.3 mL (range, 15-550 mL), the mean length of stay in the hospital was 25.3 hours (range, 23- 48 hours), and the complication rate was 0%. The rate of conversion to laparotomy was 8%. The median surgical time was 109.6 minutes (range, 99 -145 minutes).

Conclusion: Robotic-assisted total laparoscopic hysterectomy can be a safe and effective method of performing hysterectomies in select morbidly obese patients, allowing them the opportunity to undergo minimally invasive surgery without increased perioperative complications.

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Figures

Figure 1.
Figure 1.
Countertraction provided by use of towel clips to insert Veress needle at 90° transumbilical angle.
See this image and copyright information in PMC

References

    1. Olive DL, Parker WH, Cooper JM, Levine RL. The AAGL classification system for laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc. 2000;7(1):9–15 - PubMed
    1. Krebs HB, Helmkamp BF. Transverse periumbilical incision in the massively obese patient. Obstet Gynecol 1984;63:241–245 - PubMed
    1. Pitkin RM. Abdominal hysterectomy in obese women. Surg Gynecol Obstet 1976;142:532–536 - PubMed
    1. Nawfal AK, Orady M, Eisenstein D, Wegienka G. Effect of body mass index on robotic-assisted total laparoscopic hysterectomy. J Minim Invasive Gynecol. 2011;18(3):328–332 - PubMed
    1. O'Hanlan KA, Lopez L, Dibble SL, Garnier AC, Huang GS, Leuchtenberger M. Total laparoscopic hysterectomy: body mass index and outcomes. Obstet Gynecol. 2003;102(6):1384–1392 - PubMed

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