Influence of body habitus on feasibility and outcome of laparoscopic liver resections: a prospective study

Abstract

Body habitus has an influence on outcome of laparoscopic liver resections with high degree of difficulty, while feasibility and outcome of low difficulty resections seem not to be affected by anthropometric measures.

Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection

“…Using conversion as a marker of complexity, previous studies have highlighted several factors that increase the complexity of laparoscopic liver surgery including: increasing age, diabetes, high BMI, neoadjuvant chemotherapy and repeated resection. In addition, excessive blood loss has been associated with worse patient outcomes and should also be considered a marker of intraoperative complexity.…”

Are the current difficulty scores for laparoscopic liver surgery telling the whole story? An international survey and recommendations for the future

“…However, while these difficulty scoring systems provide useful guidance they are still not perfect as they focus entirely on tumour factors and resection type and overlook several patient factors that have been previously demonstrated to affect the difficulty of a laparoscopic liver resection including neo-adjuvant chemotherapy, repeated resection, body habitus/ Body Mass Index (BMI), Age and diabetes. [15][16][17][18][19][20] The recent publication by van der Poel et al (2017) re-enforces the importance of a step-wise progression in the training of a laparoscopic liver surgeon 21 and the ability to pre-operatively estimate of the difficulty of a specific resection is integral to this. The current absence of a difficulty score that incorporates patient, surgeon and tumour factors suggests that not all the important variables have been adequately recognised.…”

The impact of obesity on short-term outcomes after the laparoscopic liver resection: a single-institution experience

“…This questions whether other measures for body fat composition are more accurate at determining outcomes after LLR, for example, body shape index, which measures waist circumference adjusted for height and weight. Ratti et al postulate that this index may be more useful than BMI in determining the difficulty of LLR because it more accurately assesses central obesity [ 43 ].…”