Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index

Abstract:

Objective To investigate the safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index.Methods A retrospective analysis was performed for the case data of 416 patients who received robot-assisted laparoscopic total hysterectomy and 725 patients who received traditional laparoscopic total hysterectomy in The First Affiliated Hospital of Chongqing Medical University from February 2016 to April 2021. The patients were stratified according to the different levels of body mass index（non-overweight，overweight，and obese），and the two groups and the subgroups based on body mass index were compared in terms of perioperative conditions and intraoperative and postoperative complications.Results The overweight subgroup in the robot-assisted laparoscopic group had a significantly shorter time of operation than that in the traditional laparoscopic group［（125.37±50.92） min vs. （135.68±44.55） min，P<0.05］，and all three subgroups in the robot-assisted laparoscopic group had significantly lower intraoperative blood loss than those in the traditional laparoscopic group［non-overweight：（60.46±45.20） mL vs. （92.88±105.13） mL，P<0.05；overweight：（72.01±62.03） mL vs. （115.02±123.38） mL，P<0.05； obese：（65.59±37.92） mL vs. （125.16±96.07） mL，P<0.05］. The overweight and obese subgroups in the robot-assisted laparoscopic group had a significantly shorter time to first flatus than those in the traditional laparoscopic group［overweight：（2.04±0.83） d vs. （2.19±0.63） d，P<0.05；obese：（1.97±0.54） vs. （2.19±0.54） d，P<0.05］. All three subgroups in the robot-assisted laparoscopic group had a lower overall incidence rate of intraoperative and postoperative complications than those in the traditional laparoscopic group，but with no statistical significance（P>0.05）.Conclusion As for total hysterectomy in overweight and obese patients，robot-assisted laparoscopy has certain advantages over traditional laparoscopy in reducing perioperative complications.