Abstract
Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult.
 Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy.
 Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each
 Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups.
 Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy.
Highlights
Excess of body weight has become a global pandemic and the prevalence of overweight and obesity is increasing at an alarming rate.[1, 2] The prevalence of obesity among women worldwide increased from 6.4% in 1975 to 14.9% in 2014
Movement and placement of laparoscopic instrument and visualiza on of opera ng field may be difficult during the total laparoscopic hysterectomy (TLH) due to increased skin thickness and excess omental fat.[7]
We aim at assessing impact of high Body Mass Index (BMI) on the periopera ve outcome of total laparoscopic hysterectomy in Birat Medical College Teaching Hospital. This is a compara ve cross sec onal study conducted in 190 pa ents who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020
Summary
Excess of body weight has become a global pandemic and the prevalence of overweight and obesity is increasing at an alarming rate.[1, 2] The prevalence of obesity among women worldwide increased from 6.4% in 1975 to 14.9% in 2014. If present trends con nue, global obesity prevalence among women will surpass 21% by 2025.3 Body mass index (BMI) is calculated by dividing the weight in kilograms by square of height in meters. Movement and placement of laparoscopic instrument and visualiza on of opera ng field may be difficult during the TLH due to increased skin thickness and excess omental fat.[7] Obesity is associated with several comorbidi es such as coronary heart disease and diabetes mellitus[8] and the comorbidites nega vely affect surgical outcome.[9] Butwith improved instrumenta on and techniques, many advanced laparoscopic opera ons have been seen to be safe and feasible in women with high BMI.[10,11]
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