title: Body Mass Index and Its Role in Total Laparoscopic Hysterectomy.
abstract: Objective. To evaluate operative and perioperative outcomes in patients undergoing total laparoscopic hysterectomy according to their body mass index. Method. A retrospective study was performed for patients undergoing total laparoscopic hysterectomy at a tertiary care center for a period of 4 years. Patients were divided into two groups: obese (BMI > 30 Kg/m(2)) and nonobese (BMI < 30 Kg/m(2)). Duration of surgery, intraoperative blood loss, successful laparoscopic completion, and intraoperative complications were compared in two groups. Result. A total of 253 patients underwent total laparoscopic hysterectomy from January 2010 to December 2013. Out of them, 105 women (41.5%) had a BMI of more than 30 kg/m(2). Overall, the mean blood loss was 85.79 ± 54.17 mL; the operative time was 54.17 ± 19.83 min. The surgery was completed laparoscopically in 244 (96.4%) women while laparotomy was done in 4 cases and vaginal suturing and closure of vault were done in 5 cases. Risk of vaginal assistance was higher in obese patients whereas out of the 4 conversions to laparotomy 3 had BMI < 30 kg/m(2). The operative time was increased as the BMI of patient increased. Conclusions. Total laparoscopic hysterectomy is a safe and effective procedure for obese patients and can be performed with an efficacy similar to that in nonobese patients.
authors.affiliation: Department of Obstetrics and Gynaecology, Sri Aurobindo Institute of Medical Sciences, Indore Ujjain Highway, Indore 453111, India.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Bhandari
authors.affiliation: Department of Obstetrics and Gynaecology, Sri Aurobindo Institute of Medical Sciences, Indore Ujjain Highway, Indore 453111, India.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Agrawal
authors.affiliation: Department of Obstetrics and Gynaecology, Sri Aurobindo Institute of Medical Sciences, Indore Ujjain Highway, Indore 453111, India.
authors.forename: Aparna
authors.initials: A
authors.lastname: Singh