Laparoscopic pelvic lymphadenectomy in obese women with gynecologic malignancies

Laparoscopic pelvic lymphadenectomy was performed successfully in 10 women weighing over 180 pounds (mean 212 lbs) in conjunction with simple (7) or radical (3) hysterectomy for carcinoma of the endometrium or cervix. Four patients had extensive lysis of adhesions in addition, and one had a myomectomy to allow access to the cul-de-sac. Mean operating time was approximately 4 hours (range 2.5-7 hrs), mean blood loss 1030 ml (range 300-2000 ml), and median hospital stay 3.5 days. The average number of lymph nodes recovered was 33 (range 11-49 nodes). It is concluded that obesity, even in the presence of other pelvic pathology, does not significantly limit the feasibility of pelvic lymphadenectomy. This finding is important to the laparoscopic management of women with endometrial carcinoma.