Robotic Hysterectomy for Endometrial Cancer in Class III Obesity: 13 Years of Experience From a UK Epicentre in Guildford
ABSTRACT
Background
Surgery in morbidly obese patients is technically challenging; however, this can be mitigated using robotic surgery. We present 13‐years’ experience of robotic hysterectomy in patients with Class‐III obesity (BMI≥ 40 kg/m) and endometrial cancer.
Materials and Methods
This retrospective cohort study included 236 women with Class‐III obesity who underwent robotic hysterectomy for endometrial cancer between 2010 and 2023. Key outcomes include, completion rates and peri‐operative events. Comparative analysis evaluated outcomes following technological upgrades, introduction of sentinel lymph‐node assessment and surgeons' learning curve. Statistical analysis used Fisher's exact test and Chi‐squared for categorical variables, and ANOVA and Kruskall‐Wallis tests for continuous variables.
Results
Robotic hysterectomy was completed in 91.5% (216/236), with conversion to laparotomy in 2.5% (6/236). Median inpatient admission was 1 day. Infection occurred in 6.9% (15/216). A statistically significant decrease in laparotomies from 11% (9/236) (2010–2015) to 0% (2020–2023) (p = 0.004) was observed.
Conclusion
Robotic Hysterectomy can be safely completed in majority of morbidly obese patients with endometrial cancer with minimal perioperative complications.