Robotic surgery for endometrial cancer in patients with high body mass index: A retrospective analysis of the Department of Gynecologic Oncology at S.S. Yudin City Clinical Hospital (Moscow)

Introduction. Obesity is one of the major risk factors for endometrial cancer and significantly complicates surgical treatment due to technical challenges, limited visualization of the operative field, and an increased risk of perioperative complications. Robotic-assisted surgery has emerged as a promising minimally invasive approach capable to overcome these limitations.

Aim. To evaluate the impact of obesity severity on perioperative outcomes of robotic-assisted surgery in patients with endometrial cancer.

Materials and methods. This retrospective single-center study included 102 patients with endometrial cancer and class I–III obesity who underwent robotic-assisted surgery. Patients were stratified into three groups according to class of obesity. The operative time, estimated blood loss, length of postoperative hospital stay, and perioperative complications were assessed.

Results. No statistically significant differences in operative time were observed among the BMI groups (p >0.05). Patients with class III obesity had higher intraoperative blood loss compared with those with class I and II obesity; however, the absolute blood loss remained low. In addition, morbidly obese patients had a significantly longer postoperative hospital stay, with a median of 4 days versus 2 days in the other groups. Perioperative complications occurred in 2 patients (1.96 %) and did not require reoperation.

Conclusion. Robotic-assisted surgery is a safe and effective treatment modality for endometrial cancer in patients with varying class of obesity.

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