Geburtshilfe Frauenheilkd 2014; 74 - PO_Gyn_Uro03_07
DOI: 10.1055/s-0034-1388284

Robot assisted gynaecologic procedures in morbidly obese patients

C Kurzeder 1, J Persson 2, A du Bois 3, P Kannisto 4, T Bossmar 2, C Borgfeldt 2, F Heitz 5, K El Khalfaoui 5, A Traut 5, P Harter 5
  • 1Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Gynäkologie & Gynäkologische Onkologie, Essen, Germany
  • 2Lund University, Lund, Sweden
  • 3Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
  • 4Lund University, Department of Obstetrics and Gynaecology, Lund, Sweden
  • 5Kliniken Essen-Mitte, Essen, Germany

Objectives: The study aims to evaluate perioperative morbidity in morbidly obese women undergoing robot-assisted surgery for malignant and benign conditions in gynaecology.

Methods: A retrospective review was conducted to analyze morbidly obese patients with a body mass index (BMI) of ≥40 kg/m2 who underwent elective pelvic robotic surgery for a gynecologic procedure at one of two tertiary referral center for gynaecology and gynaecologic oncology. Patients' demographics, surgical indication, intraoperative complications and perioperative morbidity were analyzed.

Results: Between January 2008 and March 2014, 79 morbidly obese patients underwent elective pelvic robotic surgery for a gynecologic procedure including 57 (72.2%) patients with the diagnosis of a malignant disease and 22 (27.8%) patients with a benign condition. The median BMI was 45 with a range from 40 to 69. Procedures carried out included total and radical hysterectomy, adnexal surgery, pelvic and paraaortic lymph node dissection, appendectomy, omentectomy, and myomectomy. Intraoperatively 3 patients (3.8%) required repair of visceral organ or vessel damage, 4 patients (5.1%) required conversion to laparotomy due to extensive adhesions, inadequate exposure for the procedure or technical difficulties. Postoperatively 3 patients (3.8%) required secondary surgery due to intraabdominal bleeding, vaginal cuff dehiscence or trocar site bowel herniation.

Conclusions: Our results suggest that robot assisted procedures in gynaecology and gynaecologic oncology can be performed with acceptable morbidity in morbidly obese patients. Due to the low rate of wound healing complications robotic surgery should be considered as preferred surgical approach.