Robotic-assisted, laparoscopic, and vaginal hysterectomy in morbidly obese patients with endometrial hyperplasia and endometrial cancer

• Published in: Minimally invasive therapy and allied technologies Vol. 33; no. 6; p. 358
• Main Authors: Giannini, Andrea, D'Oria, Ottavia, Vizza, Enrico, Congiu, Mario A, Cuccu, Ilaria, Golia D'Augè, Tullio, Saponara, Stefania, Capalbo, Giuseppe, Di Donato, Violante, Raspagliesi, Francesco, Bogani, Giorgio
• Format: Journal Article
• Language: English
• Published: England 02.12.2024
• Subjects: Adult; Aged; Endometrial Hyperplasia - complications; Endometrial Hyperplasia - surgery; Endometrial Neoplasms - complications; Endometrial Neoplasms - surgery; Female; Humans; Hysterectomy - methods; Hysterectomy, Vaginal - methods; Laparoscopy - methods; Middle Aged; Obesity, Morbid - complications; Obesity, Morbid - surgery; Operative Time; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Robotic Surgical Procedures - methods; Treatment Outcome; laparoscopy; robotic-assisted; Endometrial cancer; vaginal hysterectomy; obesity
• ISSN: 1365-2931
• DOI: 10.1080/13645706.2024.2407845

Hysterectomy for endometrial hyperplasia and endometrial cancer in morbidly obese patients is challenging. Here, we reported data regarding three minimally invasive approaches. This is a multicenter retrospective study evaluating 30-day and 90-day surgery-related outcomes of morbidly obese patients (those with BMI > 40kg/m ) undergoing robotic-assisted, laparoscopic, and vaginal hysterectomy. Charts of 95 morbidly obese patients who underwent surgery for endometrial cancer were retrieved. Overall, robotic-assisted, laparoscopic, and vaginal surgeries were performed in 35 (36.8%), 38 (40%), and 22 (23.2%) patients, respectively. Patients having robotic-assisted surgery experienced longer operative time than patients having vaginal and laparoscopic approaches (  < 0.001). Surgical approaches did not influence the risk of having intraoperative and severe (Clavien-Dindo grade 3 or more) postoperative complications. No 90-day mortality occurred. Robotic-assisted, laparoscopic, and vaginal surgery represent three safe and feasible minimally invasive approaches to manage morbidly obese patients with endometrial hyperplasia and endometrial cancer.