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Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.

Geppert, Barbara LU ; Aardal Lönnerfors, Celine LU and Persson, Jan LU (2011) In Acta Obstetricia et Gynecologica Scandinavica 90. p.1210-1217
Abstract
Objective. Comparison of surgical results on obese patients undergoing hysterectomy by robot-assisted laparoscopy or laparotomy. Setting. University hospital. Methods. All women (n=114) with a BMI ≥30 kg/m(2) who underwent a simple hysterectomy as the main surgical procedure between November 2005 and November 2009 were identified. Robot-assisted procedures (n=50) were separated into an early (learning phase) and a late (consolidated phase) group; open hysterectomy was considered an established method. Relevant data was retrieved from prospective protocols (robot) or from computerized patient charts (laparotomy) until 12 months after surgery. Complications leading to prolonged hospital stay, readmission/reoperation, intravenous antibiotic... (More)
Objective. Comparison of surgical results on obese patients undergoing hysterectomy by robot-assisted laparoscopy or laparotomy. Setting. University hospital. Methods. All women (n=114) with a BMI ≥30 kg/m(2) who underwent a simple hysterectomy as the main surgical procedure between November 2005 and November 2009 were identified. Robot-assisted procedures (n=50) were separated into an early (learning phase) and a late (consolidated phase) group; open hysterectomy was considered an established method. Relevant data was retrieved from prospective protocols (robot) or from computerized patient charts (laparotomy) until 12 months after surgery. Complications leading to prolonged hospital stay, readmission/reoperation, intravenous antibiotic treatment or blood transfusion were considered significant. The surgical technique used for morbidly obese patients is described. Results. Women in the late robot group (n=25) had shorter inpatient time (1.6 compared to 3.8 days, p<0.0001), less bleeding (100 compared to 300 mL, p<0.0001) and fewer complications (2/25 compared to 23/64, p=0.006) than women with open surgery (n=64) but a longer operating time (136 compared to 110 minutes, p=0.0004). For women with a BMI ≥35 kg/m(2) , surgical time in the late robot group and the laparotomy group was equal (136 compared to 128 minutes, p=0.31). Conclusions. Robot-assisted laparoscopic hysterectomy in a consolidated phase in obese women is associated with shorter hospital stay, less bleeding and fewer complications compared to laparotomy but, apart from women with BMI ≥35, a longer operative time. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
90
pages
1210 - 1217
publisher
Wiley-Blackwell
external identifiers
  • PMID:21854364
  • Scopus:80054752837
  • WOS:000296489700005
ISSN
1600-0412
DOI
10.1111/j.1600-0412.2011.01253.x
language
English
LU publication?
yes
id
ee0e71a9-b4ea-4688-a5bd-05a032266971 (old id 2150822)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21854364?dopt=Abstract
date added to LUP
2011-10-03 13:41:05
date last changed
2016-12-04 04:37:35
@misc{ee0e71a9-b4ea-4688-a5bd-05a032266971,
  abstract     = {Objective. Comparison of surgical results on obese patients undergoing hysterectomy by robot-assisted laparoscopy or laparotomy. Setting. University hospital. Methods. All women (n=114) with a BMI ≥30 kg/m(2) who underwent a simple hysterectomy as the main surgical procedure between November 2005 and November 2009 were identified. Robot-assisted procedures (n=50) were separated into an early (learning phase) and a late (consolidated phase) group; open hysterectomy was considered an established method. Relevant data was retrieved from prospective protocols (robot) or from computerized patient charts (laparotomy) until 12 months after surgery. Complications leading to prolonged hospital stay, readmission/reoperation, intravenous antibiotic treatment or blood transfusion were considered significant. The surgical technique used for morbidly obese patients is described. Results. Women in the late robot group (n=25) had shorter inpatient time (1.6 compared to 3.8 days, p&lt;0.0001), less bleeding (100 compared to 300 mL, p&lt;0.0001) and fewer complications (2/25 compared to 23/64, p=0.006) than women with open surgery (n=64) but a longer operating time (136 compared to 110 minutes, p=0.0004). For women with a BMI ≥35 kg/m(2) , surgical time in the late robot group and the laparotomy group was equal (136 compared to 128 minutes, p=0.31). Conclusions. Robot-assisted laparoscopic hysterectomy in a consolidated phase in obese women is associated with shorter hospital stay, less bleeding and fewer complications compared to laparotomy but, apart from women with BMI ≥35, a longer operative time.},
  author       = {Geppert, Barbara and Aardal Lönnerfors, Celine and Persson, Jan},
  issn         = {1600-0412},
  language     = {eng},
  pages        = {1210--1217},
  publisher    = {ARRAY(0x8e60790)},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.},
  url          = {http://dx.doi.org/10.1111/j.1600-0412.2011.01253.x},
  volume       = {90},
  year         = {2011},
}