INTRODUCTION: Before the introduction of robotic surgery at our institution, most obese women of class 2 or greater (body mass index [BMI] >35) underwent a laparotomy for the management of endometrial cancer. Since November 2008, we have performed most of these cases in a robotic fashion. This manuscript presents the outcome of these women in comparison with a historical cohort of women treated with laparotomy. METHODS: Women with clinical stage I or II endometrial cancer and a BMI greater than 35 kg/m treated with robotic surgery at our institution between November 2008 and November 2010 were compared with a historical cohort of similar patients who underwent laparotomy. Patients' characteristics, operating room time, type of surgery, length of hospital stay, and incidence of perioperative complications were compared between the 2 groups. RESULTS: A total of 86 women were analyzed in this study (robotic surgery, 45; laparotomy, 41). The overall intraoperative complication rate is 5.8%. There is no statistical difference in age, number of comorbidities, BMI, prior abdominal surgery, and operative complications between the women who underwent robotic surgery versus laparotomy. Postoperative complication rates are higher in the laparotomy group (44% vs 17.7%; P = 0.007), and hospital length of stay is also higher in the laparotomy group (4 vs 2 days; P < 0.001). There is no difference in rates of (pelvic) lymph node dissection; however, para-aortic node dissection is more common in the robotic surgery group. CONCLUSION: Robotic surgery for the surgical management of the morbidly obese patient is shown to be safe and have less perioperative complications compared with open surgery.
INTRODUCTION: Before the introduction of robotic surgery at our institution, most obesewomen of class 2 or greater (body mass index [BMI] >35) underwent a laparotomy for the management of endometrial cancer. Since November 2008, we have performed most of these cases in a robotic fashion. This manuscript presents the outcome of these women in comparison with a historical cohort of women treated with laparotomy. METHODS:Women with clinical stage I or II endometrial cancer and a BMI greater than 35 kg/m treated with robotic surgery at our institution between November 2008 and November 2010 were compared with a historical cohort of similar patients who underwent laparotomy. Patients' characteristics, operating room time, type of surgery, length of hospital stay, and incidence of perioperative complications were compared between the 2 groups. RESULTS: A total of 86 women were analyzed in this study (robotic surgery, 45; laparotomy, 41). The overall intraoperative complication rate is 5.8%. There is no statistical difference in age, number of comorbidities, BMI, prior abdominal surgery, and operative complications between the women who underwent robotic surgery versus laparotomy. Postoperative complication rates are higher in the laparotomy group (44% vs 17.7%; P = 0.007), and hospital length of stay is also higher in the laparotomy group (4 vs 2 days; P < 0.001). There is no difference in rates of (pelvic) lymph node dissection; however, para-aortic node dissection is more common in the robotic surgery group. CONCLUSION: Robotic surgery for the surgical management of the morbidly obesepatient is shown to be safe and have less perioperative complications compared with open surgery.
Authors: Christen L Walters Haygood; Janelle M Fauci; Mary Katherine Huddleston-Colburn; Warner K Huh; J Michael Straughn Journal: J Robot Surg Date: 2014-03-04
Authors: Ji Yeon Park; Keun Won Ryu; Daniel Reim; Bang Wool Eom; Hong Man Yoon; Ji Yoon Rho; Il Ju Choi; Young-Woo Kim Journal: World J Surg Date: 2015-07 Impact factor: 3.352
Authors: Mario M Leitao; Wazim R Narain; Donna Boccamazzo; Vasileios Sioulas; Danielle Cassella; Jennifer A Ducie; Ane Gerda Z Eriksson; Yukio Sonoda; Dennis S Chi; Carol L Brown; Douglas A Levine; Elizabeth L Jewell; Oliver Zivanovic; Richard R Barakat; Nadeem R Abu-Rustum; Ginger J Gardner Journal: Ann Surg Oncol Date: 2016-01-07 Impact factor: 5.344