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

SIMPLE SUMMARY: Robotic surgery is reported to have benefits for the surgical management of patients with a high BMI. However, there is a lack of information on patient-reported outcomes and recovery following robotic-assisted hysterectomy (RH). A study collecting information on participant characteristics, intra- and post-operative events was conducted. Telephone questionnaires at 2, 4, 6, and 12 weeks were used to collect patient-reported recovery using the QoR-40 quality-of-recovery questionnaire. Of the 53 individuals recruited, 50 underwent RH and three cases were converted to open surgery. Patient BMI had a small impact on operative time (p = 0.04) but not on length of stay (p = 0.62). Overall quality-of-life (QOL) scores were consistently high post-operatively, indicating a high quality of recovery, and were not impacted by patient BMI. ABSTRACT: A longitudinal, descriptive, prospective, and prolective study of individuals with endometrial or cervical cancer/pre-cancer diagnoses and high BMI (over 35 kg/m(2)) 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/m(2) (range 35 to 60): the range 35–39.9 kg/m(2) had 17 cases; the range 40–44.9 kg/m(2) had 15 cases; 45–49.9 kg/m(2) 8 cases; and those ≥50 kg/m(2) 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/m(2)) and does not appear to be impacted by the severity of obesity.