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Panniculus traction and Pfannenstiel incision for hysterectomy in a super obese patient with early-stage endometrial cancer

  • Yuri Tachibana1
  • Tsutomu Ida1,*,
  • Shunya Funazaki1
  • Keijiro Sumori1

1Department of Obstetrics and Gynecology, Ome Municipal General Hospital, 198-0042 Tokyo, Japan

DOI: 10.31083/j.ejgo4204122 Vol.42,Issue 4,August 2021 pp.808-810

Submitted: 20 March 2021 Accepted: 29 April 2021

Published: 15 August 2021

*Corresponding Author(s): Tsutomu Ida E-mail: t-ida@umin.ac.jp

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Abstract

Background: We report a case of abdominal hysterectomy and bilateral salpingo-oophorectomy by Pfannenstiel incision after retraction of panniculus using the Kent retractor for a super obese patient with stage IA endometrial cancer. Case: A 40-year-old woman with stage IA endometrial cancer was transferred to our hospital for treatment. She had a BMI of 64 kg/m2. We performed abdominal hysterectomy and bilateral salpingo-oophorectomy. The panniculus was extracted using No.1 sutures with bilateral Kent retractors during surgery, which allowed us to identify the Pfannenstiel line and perform the Pfannenstiel incision. She was discharged six days after the surgery without any complication. Conclusion: Abdominal hysterectomy with retraction of panniculus and Pfannenstiel incision may be one of the feasible options for super obese patients.


Keywords

Endometrial carcinoma; Hysterectomy; Morbid obesity; Panniculus; Transverse skin incision

Cite and Share

Yuri Tachibana,Tsutomu Ida,Shunya Funazaki,Keijiro Sumori. Panniculus traction and Pfannenstiel incision for hysterectomy in a super obese patient with early-stage endometrial cancer. European Journal of Gynaecological Oncology. 2021. 42(4);808-810.

URL:

https://www.ejgo.net/articles/10.31083/j.ejgo4204122

References

[1] Bijen CBM, de Bock GH, Vermeulen KM, Arts HJG, ter Brugge HG, van der Sijde R, et al. Laparoscopic hysterectomy is preferred over laparotomy in early endometrial cancer patients, however not cost effective in the very obese. European Journal of Cancer. 2011; 47: 2158–2165.

[2] Brunes M, Johannesson U, Häbel H, Söderberg MW, Ek M. Effects of obesity on peri- and postoperative outcomes in patients undergoing robotic versus conventional hysterectomy. Journal of Minimally Invasive Gynecology. 2021; 28: 228–236.

[3] Katon JG, Gray K, Callegari L, Gardella C, Gibson C, Ma E, et al. Trends in hysterectomy rates among women veterans in the us Department of Veterans Affairs. American Journal of Obstetrics and Gynecology. 2017; 217: 428.e1–428.e11.

[4] Uccella S, Bonzini M, Palomba S, Fanfani F, Ceccaroni M, Seracchioli R, et al. Impact of obesity on surgical treatment for endometrial cancer: a multicenter study comparing laparoscopy vs open surgery, with propensity-matched analysis. Journal of Minimally Invasive Gynecology. 2016; 23: 53–61.

[5] Zoorob D, Zarudskaya O, Van Hook J, Moussa HN. Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review. Future Science OA. 2020; 7: FSO669.

[6] Maurer E, Reuss A, Maschuw K, Aminossadati B, Neubert T, Schade-Brittinger C, et al. Superficial surgical site infection following the use of intracutaneous sutures versus staples. Deutsches Ärzteblatt International. 2019; 116: 365–371.

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