Study Objective:The aim of this study is to evaluate the effect of body mass index (BMI) on laparoscopic hysterectomy outcomes.Design:This was retrospective study.Setting:Minoh City Hospital, Japan.Materials and Methods:Between January 1, 2014, and June 30, 2017, 183 patients underwent total laparoscopic hysterectomy (TLH) at our institution.Intervention:Patients who underwent TLH were grouped according to BMI, as follows: underweight group (BMI <18.5 kg/m2), normal-weight group (18.5 ≤BMI <25 kg/m2), overweight group (25 ≤BMI <30 kg/m2), and obese group (BMI ≥30 kg/m2).Measurements and Main Results:Information on patients’ clinical characteristics and surgical results were collected retrospectively by medical record review. The severity of complications was graded according to the Clavien–Dindo classification. We assessed clinical characteristics, surgical results, and the perioperative complications in each BMI group. Surgical results included operation time, nonsurgical operating room time estimated blood loss, uterine weight, and postoperative hospital stay. Compared with the normal-weight group, the obese group had significantly more complications (P = 0.012) and longer operation time (P = 0.04). The underweight and overweight groups did not have significantly different surgical results than the normal-weight group.Conclusion:Underweight and overweight patients had no significant differences in surgical results, compared with patients of normal weight. Obese patients had significantly longer operation times and more perioperative complications than patients with normal weight. Laparoscopic hysterectomy has burdens and risks for obese patients. Our results suggest that appropriate weight control may decrease the risk of surgery for obese patients.

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Objective: To evaluate the preoperative factors associated with difficulty in performing total laparoscopic hysterectomy (TLH) and to develop a statistical model predicting surgical outcomes of TLH.

Adult granulosa cell tumors are rare ovarian malignancies. They are usually stage I tumors and have a relatively good prognosis. Surgery is the mainstay of primary therapy. Recent studies showed that a minimally invasive laparoscopic approach is an option for selected patients with adult granulosa cell tumors. We report the case of a 91-year-old woman with an 18 cm solid adult granulosa cell tumor treated with laparoscopic surgery. The patient complained of pelvic discomfort and was found to have a solid ovarian tumor. The tumor was expected to be an early-stage sex cord-stromal tumor such as a granulosa cell tumor or thecoma because of the pelvic magnetic resonance imaging findings and abnormal hormonal blood test results. She underwent laparoscopic bilateral salpingo-oophorectomy. We successfully performed laparoscopic surgery in an elderly woman with an 18-cm solid adult granulosa cell tumor without scattering and spillage of the tumor, using a Vagi-Bag. She had no perioperative complications and recovery was rapid. She was doing well and disease-free at 8 months of follow-up.

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