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- W3007164393 abstract "To compare the outcomes of laparoscopic-assisted myomectomy (LAM) in morbidly obese patients (BMI ≥ 40 k/m2) versus non-obese patients (BMI < 30 k/m2) and obese patients (BMI ≥ 30 and < 40 k/m2) at a freestanding ambulatory surgery center. A retrospective comparative analysis was performed of 1,143 women, age 18 years or older, non-pregnant, who underwent LAM by one of two laparoscopic gynecologic surgical specialists at a freestanding ambulatory surgery center serving the Washington, DC, area, between October 2013 and February 2019. The study was deemed exempt from informed consent according to 45 CFR 46.101(b) by IntegReview IRB, an independent institutional review board. Blood loss was controlled by uterine artery occlusion, reversible and/or permanent. Reversible occlusion performed by placing a laparoscopic silicone tourniquet around the isthmus of the uterus, causing a causing temporary occlusion of the bilateral uterine arteries; permanent occlusion performed via retroperitoneal dissection and uterine artery ligation at the origin at the anterior branch of the internal iliac artery. Minilaparotomy performed for specimen removal in all cases. No power morcellation used. Postoperative complications graded using the Clavien-Dindo Classification system. Estimated blood loss (EBL) was higher in morbidly obese patients, but the 103 mL difference is not considered clinically meaningful. No significant difference in intraoperative complications was seen across BMI categories. Grade 2 postoperative complication rate was significantly higher in both obese and morbidly obese patients, and consisted of blood transfusions and incisional infections treated with antibiotics, with a similar distribution in all three groups. Low rate of hospital transfers in all patients (Table 1, Figure 1). Laparoscopic-assisted myomectomy can be performed safely in a freestanding ambulatory surgery setting, even in obese and morbidly obese patients.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W3007164393 date "2020-03-01" @default.
- W3007164393 modified "2023-09-25" @default.
- W3007164393 title "22: Laparoscopic-assisted myomectomy with uterine artery occlusion in morbidly obese patients at a freestanding ambulatory surgery center" @default.
- W3007164393 doi "https://doi.org/10.1016/j.ajog.2019.12.062" @default.
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