title: Effect of body mass index on robotic-assisted total laparoscopic hysterectomy.
abstract: OBJECTIVE
  To estimate the impact of body mass index (BMI) on the surgical outcomes of patients undergoing robotic-assisted total laparoscopic hysterectomy.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Henry Ford Health System academic medical center (Henry Ford and Henry Ford West Bloomfield Hospitals)
  
  
  METHODS
  A 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.
  
  
  METHODS
  Patients underwent robotic-assisted total laparoscopic hysterectomy as the intention to treat. Two cases were converted to laparotomy. MEASUREMENTS & MAIN RESULTS: Electronic medical records of all patients that underwent robotic-assisted total laparoscopic hysterectomy at Henry Ford Health System were reviewed. Data on demographics, BMI (kg/m(2)), 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.
  
  
  CONCLUSIONS
  BMI 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.
authors.affiliation: Department of Gynecology, Obstetrics, and Women's Health, Henry Ford Hospital, Detroit, Michigan 48202, USA. anawfal1@hfhs.org
authors.forename: A Karim
authors.initials: AK
authors.lastname: Nawfal
authors.forename: Mona
authors.initials: M
authors.lastname: Orady
authors.forename: David
authors.initials: D
authors.lastname: Eisenstein
authors.forename: Ganesa
authors.initials: G
authors.lastname: Wegienka
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D011183:Postoperative Complications; D012189:Retrospective Studies; D012371:Robotics; D018709:Statistics, Nonparametric; D013997:Time Factors; D014591:Uterine Diseases / Q000473:pathology* / Q000601:surgery*
chemical_list: D006454:Hemoglobins