Impact of Patient Body Mass Index on Post-Operative Recovery from Robotic-Assisted Hysterectomy

Anumithra Amirthanayagam; Matthew Wood; Lucy Teece; Aemn Ismail; Ralph Leighton; Annie Jacob; Supratik Chattopadhyay; Quentin Davies; Esther L Moss

doi:10.3390/cancers15174335

Impact of Patient Body Mass Index on Post-Operative Recovery from Robotic-Assisted Hysterectomy

Cancers (Basel). 2023 Aug 30;15(17):4335. doi: 10.3390/cancers15174335.

Authors

Anumithra Amirthanayagam¹, Matthew Wood², Lucy Teece³, Aemn Ismail², Ralph Leighton⁴, Annie Jacob⁴, Supratik Chattopadhyay², Quentin Davies², Esther L Moss^{1

2}

Affiliations

¹ Leicester Cancer Research Centre, College of Life Sciences, University of Leicester, University Road, Leicester LE1 7RH, UK.
² Department of Gynaecological Oncology, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, UK.
³ Department of Population Health Sciences, College of Life Sciences, University of Leicester, University Road, Leicester LE1 7RH, UK.
⁴ Department of Anaesthetics, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, UK.

Abstract

A longitudinal, descriptive, prospective, and prolective study of individuals with endometrial or cervical cancer/pre-cancer diagnoses and high BMI (over 35 kg/m²) undergoing RH was conducted. Of the 53 participants recruited, 3 (6%) were converted to open surgery. The 50 RH participants had median BMI 42 kg/m² (range 35 to 60): the range 35-39.9 kg/m² had 17 cases; the range 40-44.9 kg/m² had 15 cases; 45-49.9 kg/m² 8 cases; and those ≥50 kg/m² comprised 10 cases. The mean RH operating time was 128.1 min (SD 25.3) and the median length of hospital stay was 2 days (range 1-14 days). Increased BMI was associated with small, but statistically significant, increases in operating time and anaesthetic time, 65 additional seconds and 37 seconds, respectively, for each unit increase in BMI. The median self-reported time for individuals who underwent RH to return to their pre-operative activity levels was 4 weeks (range 2 to >12 weeks). There was a significant improvement in pain and physical independence scores over time (p = 0.001 and p < 0.001, respectively) and no significant difference in scores for overall QOL, pain, or physical independence scores was found between the BMI groups. Patient-reported recovery and quality of life following RH is high in individuals with high BMI (over 35 kg/m²) and does not appear to be impacted by the severity of obesity.

Keywords: body mass index; endometrial cancer; minimally invasive surgery; obesity; quality of life; robotic surgery.

Grants and funding

No grant funding was obtained to conduct the study. This study was supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and Leicester NIHR Biomedical Research Centre (BRC).The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. A.A. has been funded by an Intuitive Surgical Research grant (RM60G0742) to undertake the ISSUE study.