Skip to main content
SpringerLink
Log in

Laparoscopic Hysterectomy (TLH) in Obese Patients

  • Chapter
  • First Online:
Book cover Hysterectomy

  • 751 Accesses

Abstract

The advantages of laparoscopic (LPS) surgery have made it increasingly attractive as an alternative to traditional approaches for treatment of gynaecologic malignancies, especially endometrial cancers.

Many patients with gynaecologic disorders present with co-morbidity such as obesity, hypertension, and diabetes.

Abdominal surgery (LPT) is therefore exposing patients into increased risk of complications. Vaginal hysterectomy has been demonstrated as an attractive alternative for these patients, but this approach does not allow exploration of the abdominal cavity, peritoneal washing, and lymph node dissection.

Laparoscopic technique seems to overcome these disadvantages especially in extremely obese women.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ghezzi F, Cromi A, Bergamini V, Uccella S, Beretta P, Franchi M, Bolis P. Laparoscopic management of endometrial cancer in nonobese and obese women: a consecutive series. J Minim Invasive Gynecol. 2006;13:269–75.

    Article  PubMed  Google Scholar 

  2. Malur S, Possover M, Michels W, Schneider A. Laparoscopic-assisted vaginal versus abdominal surgery in patients with endometrial cancer: a prospective randomized trial. Gynecol Oncol. 2001;80:239–44.

    Article  CAS  PubMed  Google Scholar 

  3. Malzoni M, Tinelli R, Cosentino F, Perone C, Rasile M, Iuzzolino D, Malzoni C, Reich H. Total laparoscopic hysterectomy versus abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer: a prospective randomized study. Gynecol Oncol. 2009;112:126–33.

    Article  PubMed  Google Scholar 

  4. Palomba S, Falbo A, Mocciaro R, Russo T, Zullo F. Laparoscopic treatment for endometrial cancer: a meta-analysis of randomized controlled trials (RCTs). Gynecol Oncol. 2009;112:415–21.

    Article  PubMed  Google Scholar 

  5. Galaal K, Bryant A, Fisher AD, Al-Khaduri M, Kew F, Lopes AD. Laparoscopy versus laparotomy for the management of early stage endometrial cancer. Cochrane Database Syst Rev 2012;(9):CD 006655.

    Google Scholar 

  6. Perrone AM, Di Marcoberardino B, Rossi M, Pozzati F, Pellegrini A, Procaccini M, Santini D, De Iaco P. Laparoscopic versus laparotomic approach to endometrial cancer. Eur J Gynaecol Oncol. 2012;33:376–81.

    CAS  PubMed  Google Scholar 

  7. Litta P, Merlin F, Saccardi C, Pozzan C, Sacco G, Fracas M, Capobianco G, Dessole S. Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in postmenopausal women with abnormal uterine bleeding. Maturitas. 2005;50:117–23.

    Article  PubMed  Google Scholar 

  8. Kalogiannidis I, Lambrechts S, Amant F, Neven P, Van Gorp T, Vergote I. Laparoscopy-assisted vaginal hysterectomy compared with abdominal hysterectomy in clinical stage I endometrial cancer: safety, recurrence, and long-term outcome. Am J Obstet Gynecol. 2007;196:248.

    Article  PubMed  Google Scholar 

  9. Litta P, Bartolucci C, Saccardi C, Codroma A, Fabris A, Borgato S, Conte L. Atypical endometrial lesions: hysteroscopic resection as an alternative to hysterectomy. Eur J Gynaecol Oncol. 2013;34:51–3.

    CAS  PubMed  Google Scholar 

  10. Mariani A, Webb MJ, Galli L, Podratz KC. Potential therapeutic role of para-aortic lymphadenectomy in node-positive endometrial cancer. Gynecol Oncol. 2000;76:348–56.

    Article  CAS  PubMed  Google Scholar 

  11. Lu Q, Liu H, Liu C, Wang S, Li S, Guo S, Lu J, Zhang Z. Comparison of laparoscopy and laparotomy for management of endometrial carcinoma: a prospective randomized study with 11-year experience. J Cancer Res Clin Oncol. 2013;139:1853–9.

    Article  PubMed  Google Scholar 

  12. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, Spiegel G, Barakat R, Pearl ML, Sharma SK. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009;27:5331–6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Brezina PR, Beste TM, Nelson KH. Does route of hysterectomy affect outcome in obese and nonobese women? JSLS. 2009;13:358–63.

    PubMed  PubMed Central  Google Scholar 

  14. Nawfal AK, Orady M, Eisenstein D, Wegienka G. Effect of body mass index on robotic-assisted total laparoscopic hysterectomy. J Minim Invasive Gynecol. 2011;18:328–32.

    Article  PubMed  Google Scholar 

  15. Bardens D, Solomayer E, Baum S, Radosa J, Gräber S, Rody A, Juhasz-Böss I. The impact of the body mass index (BMI) on laparoscopic hysterectomy for benign disease. Arch Gynecol Obstet. 2014;289:803–7.

    Article  PubMed  Google Scholar 

  16. Harmanli O, Esin S, Knee A, Jones K, Ayaz R, Tunitsky E. Effect of obesity on perioperative outcomes of laparoscopic hysterectomy. J Reprod Med. 2013;58:497–503.

    PubMed  Google Scholar 

  17. Fanfani F, Boruta DM, Fader AN, Vizza E, Growdon WB, Kushnir CL, Corrado G, Scambia G, Turco LC, Fagotti A. Feasibility and surgical outcome in obese vs. non-obese patients undergoing Laparo-Endoscopic Single-Site (LESS) hysterectomy: a multicenter case-control study. J Minim Invasive Gynecol. 2014;12:401–10.

    Google Scholar 

  18. Barakat RR, Lev G, Hummer AJ, Sonoda Y, Chi DS, Alektiar KM, Abu-Rustum NR. Twelve-year experience in the management of endometrial cancer: a change in surgical and postoperative radiation approaches. Gynecol Oncol. 2007;105:150–6.

    Article  PubMed  Google Scholar 

  19. Seamon LG, Cohn DE, Henretta MS, Kim KH, Carlson MJ, Phillips GS, Fowler JM. Minimally invasive comprehensive surgical staging for endometrial cancer: robotics or laparoscopy? Gynecol Oncol. 2009;113:36–41.

    Article  PubMed  Google Scholar 

  20. Tinelli R, Malzoni M, Cicinelli E, Fiaccavento A, Zaccoletti R, Barbieri F, Tinelli A, Perone C, Cosentino F. Is early stage endometrial cancer safely treated by laparoscopy? Complications of a multicenter study and review of recent literature. Surg Oncol. 2011;20:80–7.

    Article  PubMed  Google Scholar 

  21. Malzoni M, Tinelli R, Cosentino F, Fusco A, Malzoni C. Total laparoscopic radical hysterectomy versus abdominal radical hysterectomy with lymphadenectomy in patients with early cervical cancer: our experience. Ann Surg Oncol. 2009;16:1316–23.

    Article  PubMed  Google Scholar 

  22. Malzoni M, Tinelli R, Cosentino F, Perone C, Vicario V. Feasibility, morbidity, and safety of total laparoscopic radical hysterectomy with lymphadenectomy: our experience. J Minim Invasive Gynecol. 2007;14:584–90.

    Article  PubMed  Google Scholar 

  23. Palomba S, Ghezzi F, Falbo A, Mandato VD, Annunziata G, Lucia E. Laparoscopic versus abdominal approach to endometrial cancer: a 10-year retrospective multicenter analysis. Int J Gynecol Cancer. 2012;22:425–33.

    Article  PubMed  Google Scholar 

  24. Tinelli R, Malzoni M, Cosentino F, Perone C, Fusco A, Cicinelli E, Nezhat F. Robotics versus laparoscopic radical hysterectomy with lymphadenectomy in patients with early cervical cancer: a multicenter study. Ann Surg Oncol. 2011;18:2622–8.

    Article  PubMed  Google Scholar 

  25. Tinelli R, Litta P, Meir Y, Surico D, Leo L, Fusco A, Angioni S, Cicinelli E. Advantages of laparoscopy versus laparotomy in extremely obese women (BMI > 35) with early-stage endometrial cancer: a multicenter study. Anticancer Res. 2014;34:2497–502.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of OB/GYN, Perrino Hospital, Brindisi, 72100, Italy

    Raffaele Tinelli

  2. Department of OB/GYN, University Medical School of Bari, Bari, Italy

    Ettore Cicinelli

Authors
  1. Raffaele Tinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ettore Cicinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raffaele Tinelli .

Editor information

Editors and Affiliations

  1. Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Ibrahim Alkatout

  2. Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Liselotte Mettler

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Tinelli, R., Cicinelli, E. (2018). Laparoscopic Hysterectomy (TLH) in Obese Patients. In: Alkatout, I., Mettler, L. (eds) Hysterectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-22497-8_49

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22497-8_49

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22496-1

  • Online ISBN: 978-3-319-22497-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation