Our Summary

This research study was conducted in a French teaching hospital and aimed to compare the surgical outcomes of a specific type of hysterectomy called vNOTES in patients with different body mass indexes (BMIs). The patients were divided into two groups based on their BMI: less than 30 and 30 or more. The researchers considered several factors, including how often the surgery needed to be changed during the operation, blood loss, how long the surgery took, and complications both during and after the surgery.

The study found that there was no significant difference between patients with a BMI less than 30 and those with a BMI of 30 or more in terms of changing the surgery during the operation, blood loss, and complications. However, the surgery did take a bit longer in patients with a BMI of 30 or more. They also found that the patient’s BMI did not impact whether the surgery could be completed in a day or not.

In simpler terms, the study suggests that this type of hysterectomy seems to work just as well for patients who are obese as it does for those who are not. Whether the patient was obese or not did not affect whether they had to stay in the hospital overnight after the surgery. However, more research is needed to confirm these findings.

FAQs

  1. What factors were considered in the research study on the vNOTES hysterectomy procedure?
  2. According to the study, does a patient’s BMI impact the surgical outcomes of a vNOTES hysterectomy?
  3. Does the patient’s BMI affect the duration of the vNOTES hysterectomy surgery?

Doctor’s Tip

A doctor might advise a patient undergoing a hysterectomy to maintain a healthy weight and lifestyle before and after the surgery to optimize their recovery and reduce the risk of complications. They may also recommend discussing any concerns or questions about the surgery with their healthcare provider to ensure they have a clear understanding of the procedure and what to expect during the recovery process. Additionally, patients should follow their doctor’s post-operative instructions carefully to promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for hysterectomy include those with:

  1. Uterine fibroids that cause symptoms such as heavy menstrual bleeding, pelvic pain, or pressure
  2. Endometriosis that does not respond to other treatments
  3. Uterine prolapse, where the uterus slips down into the vaginal canal
  4. Abnormal vaginal bleeding, such as postmenopausal bleeding or abnormal bleeding between periods
  5. Gynecologic cancers, such as uterine, cervical, or ovarian cancer

Ultimately, the decision to recommend a hysterectomy will depend on the individual patient’s medical history, symptoms, and overall health. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their specific condition.

Timeline

Before the hysterectomy:

  1. Patient consults with their doctor and discusses the need for a hysterectomy.
  2. Patient undergoes pre-operative testing and evaluation to determine if they are a suitable candidate for surgery.
  3. Patient prepares for surgery by following pre-operative instructions, such as fasting and stopping certain medications.
  4. Patient undergoes the hysterectomy procedure, which may involve different techniques such as vNOTES.
  5. Patient is monitored in the recovery room immediately after surgery.

After the hysterectomy:

  1. Patient is typically monitored in the hospital for a day or two after surgery.
  2. Patient may experience pain, discomfort, and fatigue in the days following the surgery.
  3. Patient may need to take pain medication and follow post-operative care instructions to aid in their recovery.
  4. Patient may have follow-up appointments with their doctor to monitor their healing progress.
  5. Patient may gradually resume normal activities and return to work after a few weeks, depending on their individual recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy, particularly in relation to the vNOTES procedure and BMI, could include:

  1. Is the vNOTES procedure suitable for me based on my BMI?
  2. How does BMI impact the length of the surgery and potential complications?
  3. Are there any specific considerations or precautions I should take based on my BMI before undergoing the vNOTES procedure?
  4. Will my BMI affect my recovery time or the likelihood of needing to stay in the hospital overnight?
  5. Are there any additional risks or factors to consider for obese patients undergoing the vNOTES procedure compared to those with a lower BMI?

Reference

Authors: Bouchez MC, Delporte V, Delplanque S, Leroy M, Vandendriessche D, Rubod C, Cosson M, Giraudet G. Journal: J Minim Invasive Gynecol. 2023 Jul;30(7):569-575. doi: 10.1016/j.jmig.2023.03.014. Epub 2023 Mar 25. PMID: 36966918