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Robotic hysterectomy strategies in the morbidly obese patient
1Department of Obstetrics and Gynecology, University of South Alabama College of Medicine, 176 Mobile Infirmary Blvd, Mobile, AL 36607, USA. odalmeida@aol.com.
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.
