AAGL 2012: Minimally Invasive Hysterectomy May be Superior to Laparotomy for Obese Patients

Although operative time is longer as compared with laparotomy, minimally invasive hysterectomy in obese patients is safe, with less blood loss and shorter hospital stays. This research was presented at the 41st Global Congress of the American Association of Gynecologic Laparoscopists.

A total of 78 consecutive patients with a BMI of at least 30 underwent robotically assisted hysterectomy (RAH) or total laparoscopic hysterectomy (TLH) for benign indications by a single surgeon. A control group was created from computerized records of patients with similar demographics and BMI who underwent total abdominal hysterectomy (TAH).

The RAH and TLH groups saw significantly shorter hospital stays and significantly longer operating times than the TAH group, though the difference between the RAH and TLH group was not significant. There were no significant differences in intraoperative or postoperative complications, or rates of readmission to the hospital. Patients in the RAH group had lower estimated blood loss compared with the TAH group. Blood transfusion rate was significantly higher in the TAH group.

“Robotic surgery may help in complex situations such as adhesions,” said Omer Tapisiz, MD, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas.

The author also acknowledged that there were more uninsured patients and unscheduled, urgent surgeries in the open group.