Review a large number of clinical experiences and objectively describe the peroperative indicators of robotic surgery in overweight and obese patients, taking into account the evaluation of efficacy and health economic value, so as to better guide the selection of surgical procedures for complex patients.

From Feb. 2012 to Jun. 2020, 1 716 patients with gynecological malignant tumor in our department were selected, of which all underwent surgery.The basic information, data of operation index, tumor pathological characteristic were collected and analyzed with SPSS24.0 software. Operation index comprises of surgical methods, operation time (robot system including the installed time), intraoperative blood loss, number of lymph node excision, postoperative hospitalization days, exhaust time, hospitalization expenses and surgical complications.

Among the 1 716 patients with gynecologicat malignancies included in this study, 621 patients were overweight. The intraoperative blood loss of patients treated with da Vinci robot system was(127.32±120.37) ml (P<0.001); the number of lymph nodes resection was(26.38±12.07)(P<0.001); Exhaust time(1.98±0.60)days (P=0.001); Hospitalization expenses were(68 342.79±13 041.57) CNY (P<0.001), Operation time(199.63±56.97) min(P=0.350), Postoperative hospitalization(11.12±4.25) days (P=0.270). In addition, 113 obese patients in this study were treated with da Vinci robot system, and the amount of intraoperative blood loss was(119.55±89.83)ml(P<0.001), Number of lymph nodes removed (26.91±11.12)(P=0.020), Exhaust time(1.96±0.56)days (P=0.003), Hospital expenses were(65 329.79±15 360.30) CNY (P=0.090), Operation time (206.64±66.62) min(P=0.690), Postoperative hospitalization time (10.54±4.57) days(P=0.430). The intraoperative blood loss in patients with overweight cervical cancer was(130.95±118.06) ml(P<0.001). There was no significant difference in the incidence of complications between robot, laparoscopic and open surgery in overweight patients with ovarian cancer (P=0.250).

For overweight patients, the da Vinci robot system not only significantly reduce the intraoperative blood loss and conversion rate, but also increase the number of lymph node resection.It shorten the exhaust time of patients and realize the concept of rapid rehabilitation surgery. For obese patients, the da Vinci robot system doesn′t increase hospitalization costs simultaneously.Therefore, the da Vinci robot system can ensure security along with health economics value.