Outcome of total laparoscopic hysterectomy in relation to BMI – A prospective study

Abstract

Introduction: Laparoscopy can be more complicated in the obese patient, but the complications tend to decrease over time with surgical experience. The aim of this study was to know the safety of total laparoscopic hysterectomy (TLH) for benign diseases in overweight and obese women when compared with women with lesser BMI. Materials and Methods: Total of 105 cases of TLH were analysed prospectively from October 2014 to August 2016. The patients were divided into 4 groups based on BMI; underweight, normal weight, overweight and obese and the demographic data and intra and post-operative parameters were recorded until one month post-operative follow up. The data obtained was analyzed using descriptive and inferential statistics. Result: Of 105 patients, 2(1.9%) were underweight, 14(13.3%) were normal weight, 20(19.0%) were overweight and 69 (65.7%) were obese. Majority were in the age group of 40 to 50 years. Fibroid was the main indication for hysterectomy. There were more number of women with blood loss of more than 100ml in overweight and obese group but the difference was not statistically significant. None of the women in all the groups suffered any major complication. The operation time was more in obese women when compared with the other groups but the difference was not statistically different. Also, when we compared the pain scores at 6 hours, 24 hours and at discharge, we found no difference between the groups. Conclusion: TLH is safe and effective in women of all BMI categories undergoing hysterectomy for benign diseases. Keywords: TLH, BMI, Operation time, Complications, Pain score, Opioid analgesia.