title: Robotic hysterectomy strategies in the morbidly obese patient.
abstract: OBJECTIVE
  The purpose of this study was to present strategies for performing computer-enhanced telesurgery in the morbidly obese patient.
  
  
  METHODS
  This was a prospective, institutional review board-approved, descriptive feasibility study (Canadian Task Force classification II-2) conducted at a university-affiliated hospital. Twelve class III morbidly obese women with a body mass index of 40 kg/m(2) or greater were selected to undergo robotic-assisted total laparoscopic hysterectomy. Robotic-assisted total laparoscopic hysterectomy, classified as type IVE, with complete detachment of the cardinal-uterosacral ligament complex, unilateral or bilateral, with entry into the vagina was performed.
  
  
  RESULTS
  The median estimated blood loss was 146.3 mL (range, 15-550 mL), the mean length of stay in the hospital was 25.3 hours (range, 23- 48 hours), and the complication rate was 0%. The rate of conversion to laparotomy was 8%. The median surgical time was 109.6 minutes (range, 99 -145 minutes).
  
  
  CONCLUSIONS
  Robotic-assisted total laparoscopic hysterectomy can be a safe and effective method of performing hysterectomies in select morbidly obese patients, allowing them the opportunity to undergo minimally invasive surgery without increased perioperative complications.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Alabama College of Medicine, 176 Mobile Infirmary Blvd, Mobile, AL 36607, USA. odalmeida@aol.com.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Almeida
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002170:Canada; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D061646:Operative Time; D056888:Patient Positioning; D011446:Prospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome
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