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Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship

Shafa, Anousheh MD; Kumar, Amanika MD; Torres, Diogo MD; McKenzie, Travis J. MD

doi: 10.1097/AOG.0000000000003403
Contents: Gynecologic Oncology: Case Report

BACKGROUND: Surgery is curative for the majority of early-stage endometrial cancers. Postoperatively, patients are actually at much higher risk of mortality from obesity-related comorbidities unless they have sustained weight loss.

CASE: A 54-year-old woman with class III obesity, type II diabetes mellitus complicated by neuropathy and retinopathy, hypertension, sleep apnea, and fatty liver disease was diagnosed with grade 1 endometrioid uterine cancer. She underwent dual surgery with laparoscopic bariatric surgery and robotic-assisted laparoscopic hysterectomy. The perioperative period was uncomplicated, and final pathology was consistent with a stage IA grade 1 endometrial cancer. In 12 months, the patient lost 41.3 kg and required less insulin, metformin, and antihypertensive medication.

CONCLUSION: Combined minimally invasive hysterectomy and bariatric surgery for obese women with endometrial cancer can promote sustained weight loss and improve survivorship.

Dual minimally invasive hysterectomy and bariatric surgery for endometrial cancer may promote sustained weight loss and improve survivorship.

Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, and the Department of Surgery, Endocrine Subspecialty, Mayo Clinic Rochester, Minnesota.

Corresponding author: Anousheh Shafa, MD, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN; email:

Financial Disclosure Amanika Kumar disclosed that this article discusses the Mirena IUD, which was used for treatment of endometrial cancer, but has not been U.S. Food and Drug Administration (FDA)–approved for treatment of endometrial cancer and is not FDA-approved for this indication. The other authors did not report any potential conflicts of interest.

Presented at the Minnesota Surgical Society's Fall Conference, November 9–10, 2018, St. Paul, Minnesota.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.