Laparoscopic hysterectomy for obese patients

Abstract

Objective: Traditional gynecological operations, especially hysterectomy, for obese patients are very difficult, traumatic and often have complications. The aim of the study was to identify a feasible and safe technique of laparoscopic hysterectomy for these patients and to investigate the results of its application.

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Methods: The indication for laparoscopic operations was fibromyoma of uterus (9-12 weeks), complicated with frequent uterine bleeding. Laparoscopic operations were made using pneumoperitoneum of 12-14 mmHg combined with traction of the abdominal wall. After uterine mobilization by uni- and bipolar electrocautery, we placed 2-3 endoloops at the uterine neck and vessels, transected them and finished laparoscopic hysterectomy, or used vaginal approach.

Results: Laparoscopic hysterectomies (11 laparoscopic and 1 laparoscopic assisted vaginal hysterectomy) were made for 12 obese patients, 45-60 years old. The weight varied between 95-130 kg. The mean operation time was 120 minutes. We have seen no serious complications following laparoscopic operation.

Conclusions: Laparoscopic hysterectomy is safe and beneficial to the obese patients.