Synergizing health: combined gynecological and bariatric robotic surgery for endometrial cancer in obese women

Endometrial cancer is the most common gynecological tumor, with approximately 10 200 new cases in 2022 in Italy. Its incidence is on the rise, possibly linked to undefined factors, with many attributing it to the increasing rates of obesity in high-income countries. This is not an unreasonable assumption, considering the correlation between obesity and the general risk of cancer, as well as the effects of unopposed hyperestrogenism due to inadequate progesterone production from adipose tissue. Strong evidence from the literature underscores the health benefits of weight reduction. It is particularly noteworthy for women with precancerous lesions and early-stage tumors who wish to conceive. Rapid and significant weight loss can be achieved through bariatric surgery, and the combination of minimally invasive robotic surgery with sleeve gastrectomy seems to be a promising option for severely obese women (body mass index (BMI) >35 kg/m2 ) (Figure 1). This choice is supported by the minimally invasive approach recommended for endometrial cancer and the surgeon’s comfort with the robotic technique in severely obese patients