PDF(Pubmed)
Abstract：
Morbid obesity, traditionally considered to be a contraindication to total laparoscopic hysterectomy, is now evolving into an indication. Innovations and advancements in minimally invasive surgical techniques have significantly improved patient morbidity and mortality rates, reduced operational costs, and provided patients with an overall safer surgical experience. Although the laparoscopic approach is associated with several physiologic and technical challenges in the morbidly obese, it is plausible that these patients stand to benefit the most from minimally invasive surgery. This report highlights the methods of preoperative optimization, intraoperative considerations, and postoperative management strategies employed to achieve a successful total laparoscopic hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection in a patient with a BMI of 45kg/m2, diagnosed with grade 1 endometrial adenocarcinoma and several obesity-related comorbidities.
摘要：
病态肥胖,传统上被认为是全腹腔镜子宫切除术的禁忌症，现在正在演变成一个指示。微创外科技术的创新和进步显著提高了患者的发病率和死亡率,降低运营成本，并为患者提供整体更安全的手术体验。尽管腹腔镜方法与病态肥胖的一些生理和技术挑战有关，这些患者可能从微创手术中受益最大。本报告重点介绍了术前优化的方法，术中注意事项,和术后管理策略，以实现成功的全腹腔镜子宫切除术，1例BMI为45kg/m2，诊断为1级子宫内膜腺癌和几种肥胖相关合并症的患者的双侧输卵管卵巢切除术和盆腔淋巴结清扫术。
