Comorbidities like obesity, diabetes and chronic obstructive pulmonary disease (COPD) play an important role for the peri- and postoperative course and management of a hysterectomy. In most cases the laparoscopic technique is favoured compared to conventional techniques in patients with the previous mentioned risk factors. However, severe obesity in combination with COPD is itself a limiting factor for a laparoscopic approach to hysterectomy.
The presence of deep infiltrating endometriosis in patients with an indication for hysterectomy requires a preparation technique equivalent to the surgical technique of radical hysterectomy. These technically difficult and complex interventions should be performed in centres with great surgical expertise.
KeywordsComorbidities Laparoscopic hysterectomy Obesity Deep infiltrating endometriosis Frozen pelvis
- 7.Mahdi H, Goodrich S, Lockhart D, DeBernardo R, Moslemi-Kebria M. Predictors of surgical site infection in women undergoing hysterectomy for benign gynecologic disease: a multicenter analysis using the national surgical quality improvement program data. J Minim Invasive Gynecol. 2014;21(5):901–9.CrossRefPubMedGoogle Scholar
- 15.Wallwiener M, Taran FA, Rothmund R, Kasperkowiak A, Auwärter G, Ganz A, Kraemer B, Abele H, Schönfisch B, Isaacson KB, et al. Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): an implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations. Arch Gynecol Obstet. 2013;288(6):1329–39.CrossRefPubMedGoogle Scholar