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Total laparoscopic hysterectomy for benign, malignant and pre-malignant gynaecological pathology: relation between surgical outcome and body mass index

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Gynecological Surgery

Abstract

Obesity is having an increasingly significant impact on health care services across the developed world. Although initially laparoscopic surgery was thought to be contraindicated in cases of obesity, surgeons, including gynaecologists, are now routinely performing laparoscopic surgery on obese patients. Limited research has been conducted into the effect of obesity on outcomes of major laparoscopic pelvic surgery. Some authors report worsening outcomes in obese women having laparoscopic hysterectomies; others suggest that complication rates do not increase, but operating times are longer. Here, we report our experience from 250 total laparoscopic hysterectomies performed for benign, malignant and pre-malignant conditions, and we compare outcomes among normal, overweight, obese and morbidly obese patients. We used a composite score index calculated on the basis of operating and theatre times, estimated blood loss, length of stay and number and severity of complications for our comparisons. Our conclusions suggest that meticulous, consistent surgical technique may produce similar outcomes in normal and obese patients having total laparoscopic hysterectomy, with longer operating/theatre times noted only at BMI levels >40.

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Acknowledgments

This project was supported by a grant (“Inspire” grant) from the University of Liverpool.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, Wirral University Teaching Hospital, Wirral, CH49 5PE, UK

    Vasileios Minas, Claudia Ventii, Thomas Aust, David Rowlands & Nahid Gul

  2. School of Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK

    Nicola Murray

Authors
  1. Vasileios Minas
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  2. Claudia Ventii
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  3. Nicola Murray
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  4. Thomas Aust
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  5. David Rowlands
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  6. Nahid Gul
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Corresponding author

Correspondence to Vasileios Minas.

Ethics declarations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

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The authors declare that they have no conflict of interest.

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Minas, V., Ventii, C., Murray, N. et al. Total laparoscopic hysterectomy for benign, malignant and pre-malignant gynaecological pathology: relation between surgical outcome and body mass index. Gynecol Surg 13, 493–497 (2016). https://doi.org/10.1007/s10397-016-0968-y

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  • DOI: https://doi.org/10.1007/s10397-016-0968-y

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