Laparoscopic hysterectomy is preferred over laparotomy in early endometrial cancer patients, however not cost effective in the very obese

In general, TLH should be recommended as the standard surgical procedure in early stage endometrial cancer, also in patients >70 years of age. In obese patients with a BMI >35 kg/m2 TLH is not cost effective because of the high conversion rate. A careful consideration of laparoscopic treatment is needed for this subgroup. Surgeon experience level may influence this choice.