Obesity and robotic surgery: Associated ventilator indices and perioperative pulmonary complications.

Authors

Weiya Wysham

Weiya Zhang Wysham

University of North Carolina, Chapel Hill, NC

Weiya Zhang Wysham , Kenneth H Kim , Jared Roberts , Stephanie Sullivan , Sukhkamal Bhullar , Dario Roque , Dominic T. Moore , Paola A. Gehrig , John Boggess , Warner King Huh

Organizations

University of North Carolina, Chapel Hill, NC, University of Alabama, Birmingham, AL, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, The University of North Carolina at Chapel Hill, Chapel Hill, NC, The University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL

Research Funding

No funding sources reported

Background: Robotic surgery has been shown to be feasible in obese patients. However, there remains concern about the safety of robotic surgery in obese women who need gynecologic surgery, as the positioning required for pelvic surgery can exacerbate obesity-related changes in respiratory physiology. Our objective was to evaluate success and complication rates in obese women undergoing robotic gynecologic surgery and to assess variables that may be associated with complications. Methods: A retrospective chart review was performed on 1,035 obese patients who underwent robotic gynecologic surgery at two academic institutions between 2006 and 2012. Primary outcome was pulmonary complications. Secondary outcome was all-cause complications. Univariate logistic regression analysis was used to determine associations between patient baseline variables (age, BMI), operative variables (case length, trendelenburg time), ventilator parameters (tidal volume, peak inspiratory pressure) and complications (pulmonary, cardiac, other). Results: 146 patients (14%) had any complication. Only 33 patients (3%) had a pulmonary complication. Mean BMI was 39. Only increasing age was associated with a higher rate of pulmonary complications (p=0.03). None of the other patient variables including BMI, operative variables, or ventilator parameters were associated with pulmonary complications. Both age and longer case time were associated with a higher rate of all-cause complications (p<0.0005 and p=0.0028 respectively). Conclusions: The vast majority of obese patients can successfully tolerate robotic gynecologic surgery, and have overall low complications rates and even lower rates of pulmonary complications. Obesity was not predictive of robotic surgery tolerance or complications and can be safely undertaken in obese and even morbidly obese patients without significant complications.

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Abstract Details

Meeting

2014 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Citation

J Clin Oncol 32:5s, 2014 (suppl; abstr 5596)

DOI

10.1200/jco.2014.32.15_suppl.5596

Abstract #

5596

Poster Bd #

378

Abstract Disclosures

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