Effect of Body Mass Index on Robotic-Assisted Total Laparoscopic Hysterectomy

Study ObjectiveTo estimate the impact of body mass index (BMI) on the surgical outcomes of patients undergoing robotic-assisted total laparoscopic hysterectomy.DesignRetrospective cohort study.SettingHenry Ford Health System academic medical center (Henry Ford and Henry Ford West Bloomfield Hospitals)PatientsA total of 135 patients who underwent scheduled robotic-assisted total laparoscopic hysterectomy for benign indications, without concomitant urogynecologic procedures between January 2008 and June 2010.InterventionsPatients underwent robotic-assisted total laparoscopic hysterectomy as the intention to treat. Two cases were converted to laparotomy.Measurements & Main ResultsElectronic medical records of all patients that underwent robotic-assisted total laparoscopic hysterectomy at Henry Ford Health System were reviewed. Data on demographics, BMI (kg/m2), estimated blood loss, perioperative hemoglobin change, procedure duration, hospital length of stay, specimen weight, pathology, and postoperative complications were obtained. The women’s median age was 45 years (range 30–68), 61.5% were black, and BMI ranged from 14.8-56.2 kg/m2; 23.4% of women were normal weight or less (BMI <25, n = 31), 52.7% of women were obese (BMI >30, n = 70) and 36 of these patients (27.1%) were morbidly obese (BMI ≥35). BMI did not correlate with procedure duration (Spearman r = .12, p = .16), length of stay (Spearman r = .10, p = .24), or estimated blood loss (Spearman r = .12, p =.18). Our analysis did not identify any meaningful associations between BMI and absolute change in hemoglobin. In addition BMI was not associated with an increase in major or minor complications.ConclusionBMI is not associated with blood loss, duration of surgery, length of stay, or complication rates in patients undergoing robotic-assisted total laparoscopic hysterectomy. Robotic assistance may help surgeons overcome adverse outcomes sometimes found in obese patients.