Laparoscopic total abdominal hysterectomy in morbidly obese women. A pilot-phase report.
OBJECTIVE
To establish the consecutive steps in and evaluate the safety and effectiveness of laparoscopic total abdominal hysterectomy (L-TAH) (hysterectomy completed via laparoscopy, with no transvaginal approach by the suturing technique) in a group of morbidly obese women and to compare the results to a group of nonobese women with clinically similar characteristics and indications for hysterectomy.


METHODS
Eleven morbidly obese women were subjected to a L-TAH with no vaginal approach. The operation was executed by suturing and tying an extracorporeal sliding knot and by using intracorporeal two-turn flat square knot methods. The consecutive steps of the operation were changed from the original to facilitate this procedure. The group of morbidly obese women was compared to a group of nonobese women.


RESULTS
All the subjects exceeded their ideal body weight by 100%. Their actual weight ranged from 118.9 to 139.8 kg, and their height ranged from 58 to 69 in. All the planned surgery was completed, and no intraoperative or postoperative complications were observed. There was no conversion from the laparoscopic approach to a laparotomy or transvaginal path. When compared to that in the control group, the mean operating time was significantly longer in morbidly obese subjects.


CONCLUSIONS
L-TAH is safe and effective for morbidly obese women.
Ostrzenski
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Department of Obstetrics and Gynecology, Howard University College of Medicine and Hospital, Washington, D.C., USA. aostrzenski@msn.com
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D010865:Pilot Projects; D011183:Postoperative Complications; D016896:Treatment Outcome