Outcomes of obese versus non-obese subjects undergoing robotic-assisted hysterectomy

A multi-institutional study

W. B. Davenport, M. P. Lowe, D. H. Chamberlin, S. A. Kamelle, P. R. Johnson, M. Tyndall, Todd Tillmanns

Research output: Contribution to journalArticle

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Abstract

The goal of our study was to determine whether there was a difference in operative outcomes in obese versus non-obese subjects undergoing robotic-assisted hysterectomies of varying levels of difficulty. Secondarily, we sought to analyze the published outcomes between robotic-assisted hysterectomy and total laparoscopic hysterectomy in obese women at each of these levels of difficulty. This was a multi-institutional retrospective cohort study of all patients undergoing robotic-assisted hysterectomy by five gynecologic oncologists at four geographically separate locations from April 2003 to March 2008. The cohort was stratified into obese vs. non-obese groups, and defined surgical outcomes compared between groups, then further divided into three subgroups based on case difficulty level. Univariate analysis and regression analysis using SAS 9. 1 was performed. We then conducted a literature search of total laparoscopic hysterectomy outcomes in obese women, dividing the resulting studies into three comparative subgroups based on surgical difficulty levels for comparison with our robotic-assisted hysterectomy results. Our cohort had 228 obese and 323 non-obese subjects. Overall, the obese group had higher blood loss and longer operative time. When further stratified by level of difficulty, obese subjects also had a higher average blood loss and longer operative time in the hysterectomy-alone subgroup. No clinically significant differences in operative outcomes exist between obese and non-obese women when utilizing the da Vinci robotic system to perform a hysterectomy, independent of case difficulty level. More prospective, controlled studies which compare the two surgical approaches of robotic-assisted and laparoscopic hysterectomy approaches are needed.

Original languageEnglish (US)
Pages (from-to)15-20
Number of pages6
JournalJournal of Robotic Surgery
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2013

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Robotics
Hysterectomy
Operative Time
Cohort Studies
Retrospective Studies
Regression Analysis
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Health Informatics

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Outcomes of obese versus non-obese subjects undergoing robotic-assisted hysterectomy : A multi-institutional study. / Davenport, W. B.; Lowe, M. P.; Chamberlin, D. H.; Kamelle, S. A.; Johnson, P. R.; Tyndall, M.; Tillmanns, Todd.

In: Journal of Robotic Surgery, Vol. 7, No. 1, 01.01.2013, p. 15-20.

Research output: Contribution to journalArticle

Davenport, W. B. ; Lowe, M. P. ; Chamberlin, D. H. ; Kamelle, S. A. ; Johnson, P. R. ; Tyndall, M. ; Tillmanns, Todd. / Outcomes of obese versus non-obese subjects undergoing robotic-assisted hysterectomy : A multi-institutional study. In: Journal of Robotic Surgery. 2013 ; Vol. 7, No. 1. pp. 15-20.
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