Concurrent Laparoscopic Hysterectomy and Weight Loss Surgery in Obese Patients With Endometrial Carcinoma or Endometrial Intraepithelial Neoplasia
Concurrent Laparoscopic Hysterectomy and Weight Loss Surgery in Obese Patients With Endometrial Carcinoma or Endometrial Intraepithelial Neoplasia
To assess the feasibility of an expedited referral process for the obese endometrial cancer
 or EIN patient from her gynecologic oncologist to the Brigham Center for Metabolic and
 Bariatric Surgery (CMBS) in order to undergo concurrent weight loss surgery and hysterectomy
 within 8 weeks of first appointment with a gynecologic oncologist (or 12 weeks for EIN
 patients).
The most common risk factor for endometrial cancer is obesity. However, because early-stage
 endometrial cancer has a very high survival rate, patients more often suffer from long-term
 issues related to their weight, like heart disease, stroke, and diabetes. Weight loss surgery
 has been shown to help patients lose weight and also decrease their risk for obesity-related
 diseases.

 This research study is a Feasibility Study. This is the first-time investigators are studying
 both 1) the referral process of patients with endometrial cancer to the Center for Metabolic
 and Bariatric Surgery without delaying curative treatment of endometrial cancer 2) the
 combined surgery of both hysterectomy and weight loss surgery. The combined surgery of
 hysterectomy and weight loss surgery has been performed both at this institution and others
 without increased complications, but it has not been formally studied.

 Approximately 30 patients are expected to participate in this study at Brigham and Women's
 Hospital (BWH).
Inclusion Criteria:

 -  Female adults at least 18 years of age

 -  A BMI of 35-39.99 and 1 or more severe obesity-related co-morbidities

 --including T2D,112 hypertension, hyperlipidemia, obstructive sleep apnea (OSA),
 obesity-hypoventilation syndrome (OHS), Pickwickian syndrome (a combination of OSA and
 OHS), nonalcoholic 4 fatty liver disease (NAFLD) or nonalcoholic steatohepatitis
 (NASH), pseudotumor cerebri, gastroesophageal reflux disease (GERD), asthma, venous
 stasis disease, severe urinary incontinence, debilitating arthritis, or considerably
 impaired quality of life) OR a BMI ≥ 40

 -  Tissue diagnosis (usually endometrial biopsy) of grade 1 endometrial carcinoma or EIN.

 Exclusion Criteria:

 -  Younger than 18 years old

 -  BMI < 35

 -  Without a tissue diagnosis, or with a grade 2 or greater endometrial cancer tissue
 diagnosis

 -  Pregnant participants will be excluded from this study.

 -  Patients with contraindications to bariatric surgery will also be excluded.

 --This includes active smokers, prior bariatric surgery, active substance abuse,
 recent suicide attempt, bulimia nervosa, large abdominal hernias, or poorly controlled
 psychiatric illness

 -  include inability to read an English informed consent form, and unwillingness to
 provide informed consent.