Introduction/Background 70% of women with endometrial cancer are overweight or obese which increases the risk of peri-operative complications. 90% of patients with endometrial cancer who attend our tertiary gynaecological oncology unit have minimally invasive surgery (laparoscopic or robotic). We compare our intraoperative and postoperative adverse event (AE) rate (using the NCI common toxicity criteria classification), rate of conversion to laparotomy and length of hospital stay was compared to current literature (LACE trial, Lap 2 trial and the Dutch TLH trial).

Methodology A retrospective review of patients managed surgically for endometrial carcinoma was performed from July 2019 to July 2021.

Results We identified 135 patients, 83.7% of whom (n=113) underwent total laparoscopic hysterectomy (TLH). Intraoperative complications in TLH group was 4.5% (n=5), and 7.1% (n=2) in the TAH group. Post-operative complication rate in TLH was 6.5% (n=7) and 21.4% (n=6) in TAH. The average length of stay was 2 days in TLH and 7 in TAH. The intraoperative complication rate was 5.1% in those with a BMI <30, 6.7% in patients with a BMI 30–39, and 4% (n=1) in those with a BMI >40. Post-operative complication rate was 3.4% in the BMI <30 group, 11.8% in the BMI 30–39 group and 16% in the BMI >40 group.

Conclusion We found that our adverse event rate was below the average rate (of the three trials) in TLH (6.7% vs 4.5% intraoperatively and 12.9% vs 6.5% postoperatively). The rate of adverse events in our TAH group was higher than the average rate in the other three trials intra-operatively (7.1% vs 5.6%) and post-operatively (21.4% vs 16.7%).

In conclusion there was a significantly higher postoperative complication rate in the high BMI (>39) group (16%) and efforts should be made to identify modifiable risk factors in this patient population