title: Total laparoscopic hysterectomy in morbidly obese women with endometrial cancer anaesthetic and surgical complications.
abstract: OBJECTIVE
  To assess the feasibility, associated anaesthetic and surgical morbidity in all morbidly obese women with endometrial cancer treated with total laparoscopic hysterectomy bilateral salpingo-oophorectomy (TLHBSO).
  
  
  METHODS
  Data was collected prospectively and analysed retrospectively on all morbidly obese women who had TLHBSO between February 2003 and January 2007.
  
  
  RESULTS
  One case was converted to laparotomy. The mean postoperative stay was 4.04 (3-7) days. The only postoperative surgical complication was an incisional port site hernia. Comorbidities were present in 76% (26/34) of women, 29% (10/34) had a single comorbid condition, and 26% (9/34) had two. A further 21% (7/34) had more than two. There were no major anaesthetic complications. Patients with a BMI > 50 required ventilation with high airway pressure despite using ventilatory strategies to keep them to a minimum.
  
  
  CONCLUSIONS
  TLHBSO in the obese population is safe in the hands of experienced surgeons and anaesthetists. The safety of a total laparoscopic approach in the surgical management of uterine cancer remains to be demonstrated in prospective randomised trials.
authors.affiliation: Department of Womens Health, Elizabeth Garrett Anderson & Obstetric Hospital, Huntley street, London, UK. ogormantom@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: O'Gorman
authors.forename: N
authors.initials: N
authors.lastname: MacDonald
authors.forename: T
authors.initials: T
authors.lastname: Mould
authors.forename: A
authors.initials: A
authors.lastname: Cutner
authors.forename: R
authors.initials: R
authors.lastname: Hurley
authors.forename: A
authors.initials: A
authors.lastname: Olaitan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D010052:Ovariectomy; D011183:Postoperative Complications