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230 Combined hysterectomy and bariatric robotic surgery for obese women with endometrial cancer
  1. Francesco Mezzapesa1,2,
  2. Marco Tesei1,
  3. Paolo Bernante3,2,
  4. Francesca Balsamo3,
  5. Silvia Garelli4,
  6. Lucia Genovesi1,2,
  7. Enrico Fiuzzi1,2,
  8. Pietro Pasquini1,2,
  9. Anna Myriam Perrone1,2 and
  10. Pierandrea De Iaco1,2
  1. 1Division of Oncologic Gynecology IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  2. 2Department of Medical and Surgical Sciences (DIMEC), Bologna, Italy
  3. 3Division of Metabolic and Bariatric Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Bologna, Italy
  4. 4Unit of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy


Introduction/Background The incidence of endometrial cancer (EC) is increasing, partly due to rising obesity rates in high-income countries. Robotic surgery is recommended for patients with EC and severe obesity due to the less complicated surgery and anaesthesia. Furthermore, bariatric surgery is recognised as an effective and durable solution for weight loss in severely obese patients. This study aims to investigate the feasibility and 30-day morbidity outcomes of the combination of gynecological and bariatric robotic surgery.

Methodology In this retrospective case-control study, 13 patients with EC and severe obesity (BMI >35 kg/m²) who underwent standard robotic surgery for early EC, either with or without sleeve gastrectomy, were enrolled. Clinical, surgical, and follow-up data were analyzed.

Results Out of the 13 patients, only 3 (23%) chose to undergo the combined surgery. The average preoperative BMI was slightly higher in the combined surgery group (49.6 kg/m²) compared to the group without sleeve gastrectomy (42.5 kg/m²). The preoperative and post-operative average hemoglobin levels were similar in both groups (13.1 g/dL vs. 13.4 g/dL and 11.4 g/dL vs. 12 g/dL, respectively). The combined surgery took 109 minutes longer (range: 225–290 mins) than the standard surgery group (range: 95–225 mins). However, the combined surgery did not result in an increase in early and late complications, Intensive Care Unit recovery time or hospitalization time (4.6 vs. 4.5 days). In the combined surgery group, there was an average BMI decrease of 27% six months after the surgery.

Conclusion The concept of combined robotic gynecological and bariatric surgery for EC in obese women could represent a novel, safe, effective, and efficient approach to treating simultaneously this specific patient population. It has shown similar surgical and clinical outcomes to standard robotic surgery for early EC while potentially can improve the wellbeing of the patients.

Disclosures The authors do not have conflicts of interest that could affect the research, or the presentation of the results contained in this abstract.

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