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Surgical Outcome of Robotic Surgery in Morbidly Obese Patient With Endometrial Cancer Compared to Laparotomy
  1. Marcus Q. Bernardini, MD*,
  2. Lilian T. Gien, MD,
  3. Helen Tipping, RN,
  4. Joan Murphy, MD* and
  5. Barry P. Rosen, MD*
  1. * Division of Gynecologic Oncology, Princess Margaret Hospital;
  2. Division of Gynecologic Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre; and
  3. Department of Surgery,University Health Network, Toronto, Ontario, Canada.
  1. Address correspondence and reprint requests to Marcus Q. Bernardini, MD, Division of Gynecologic Oncology, Princess Margaret Hospital, M700, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada. E-mail: Marcus.bernardini{at}uhn.on.ca.

Abstract

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/m2 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.

  • Endometrial cancer
  • Robotic surgery
  • Morbid obesity

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Footnotes

  • The authors declare that there are no conflicts of interest.

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