Obesity in laparoscopic surgery

Afors, Karolina; Centini, Gabriele; Murtada, Rouba; Castellano, J. Ojeda; Meza, Carolina; Wattiez, Arnaud

doi:10.1016/j.bpobgyn.2015.02.001

Cited by 27 publications

(21 citation statements)

References 42 publications

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“…In a patient with a normal BMI, the trocar entry is usually at the umbilicus as it is the thinnest point of entry; however, in obese patients, the umbilicus moves more caudally and can prevent the surgeon from getting optimal viewing. 18 In this regard, initial entry is usually done via the left upper quadrant or via supraumbilical region. This mitigates the risk of poor triangulation as well as obstructing proper view.…”

Section: Discussionmentioning

confidence: 99%

Obesity and gynecologic surgery via minimally invasive surgery with comparison to open laparotomy; a case report and review of the literature

Guan¹,

Rezai²,

Giovane³

et al. 2019

OGIJ

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Background: Minimally invasive gynecological surgery (MIGS), has many benefits for patients, such as shorter recovery times and a decrease in postoperative pain. MIGS can prove challenging in obese patients as well. Obesity complicates MIGS due to the technical challenge for the surgeon as well as patient positioning. Often open laparotomy is done due to the aforementioned issues. However, MIGS provides better outcomes for patients. Case: We report a case of a 37 year old G1P1 with a BMI of 80.72 kg/m2 who complained of menorrhagia for 4 months. The patient was given a trial of OCP therapy for conservative treatment which did ameliorate the complaint. The patient continued to have heavy vaginal bleeding passage of large clots. Along with blood work, a pelvic ultra sound was done which showed bilateral multicystic and septated adnexal masses on the ovaries. A CT scan was also done which confirmed the mass, without a concern for malignancy. The patient was then scheduled for a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy, via laparoscopic technique. The patient tolerated the procedure well. The adnexal masses were sent to pathology which revealed serous borderline tumors of the ovaries. Conclusion: Gynecological surgery in the obese patient provides a challenge during the patient's pre, intra and postoperative management. Using MIGS, obese patients can have shorter hospital stay, with fewer complications as well as have less postoperative pain.

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Section: Discussionmentioning

confidence: 99%

Obesity and gynecologic surgery via minimally invasive surgery with comparison to open laparotomy; a case report and review of the literature

Guan¹,

Rezai²,

Giovane³

et al. 2019

OGIJ

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“…Laparoscopic surgery is safe in obese patients. However, there are some special considerations: adequate position to expand the surgical field avoiding pressure sores and minimizing nerve compression, adequate entry technique, longer operative time, and thromboprophylaxis [39].…”

Section: Obesity and Gastrointestinal Surgerymentioning

confidence: 99%

Obesity: A Risk Factor for Infection after Surgery

Suclla-Velásquez¹,

Smedts²

2020

Weight Management

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Obesity is a prevalent health problem all over the world. It is associated with several diseases including infections. It impairs the immune system function by plenty of mechanisms. For instance, leptin and adiponectin are cytokines produced by the adipose tissue, both participating in immunity, but their effects are impaired in obese patients. Moreover, immune cells also show defects in their functions. They produce a pro-inflammatory state and contribute to obesity-related diseases. Innate immune system and adaptive immunity are both impaired in obese patients which causes a poor response to infections. In addition, in surgical site infections (SSI), there are local factors that must be considered. The large adipose panicle and visceral adipose tissue increase the surgical technique difficulty and extend the operative time. Besides, the adipose tissue has poor oxygenation and reduces operative field. It has been proven that obesity is associated to surgical site infection irrespective of type of surgery. However, minimal invasive surgery has demonstrated that reducing surgical trauma can diminish the risk for surgical site infection.

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“…Особое внимание необходимо уделить гемодинамическим эффектам пневмоперитонеума и их важности с учётом коморбидности данного контингента больных. Известно, что происходит увеличение общего сосудистого сопротивления, а в ответ на уменьшение венозного возврата снижается сердечный выброс, что создаёт дополнительные трудности в обеспечении интраоперационной безопасности пациентки [4][5][6]. Таким образом, объективные сложности в лечении данной группы больных послужили причиной поиска новых способов оперативных вмешательств у больных раком эндометрия, страдающих выраженным абдоминальным ожирением [7,8].…”

Section: Clinical Studiesunclassified

Combined Approach to Surgical Treatment of Endometrial Cancer in Patients With Morbid Obesity

et al. 2020

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Аннотация Цель исследования-облегчение выполнения операций у больных с морбидным ожирением путем комбинации хирургических методов. Материал и методы. В гинекологических отделениях МниОи им. П.А. Герцена и Воронежского онкологического диспансера с января 2017 г. по декабрь 2018 г. выполнено 26 лапароскопических гистерэктомий по поводу рака эндометрия i стадии в комбинации с панникулэктомией на первом этапе. Результаты. Всем пациенткам была выполнена операция в запланированном объеме. конверсий не было ни в одном случае. не зарегистрировано интраоперационных эпизодов нестабильной гемодинамики, значимой гипоксемии или недопустимой гиперкапнии.

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Obesity in laparoscopic surgery

Cited by 27 publications

References 42 publications

Obesity and gynecologic surgery via minimally invasive surgery with comparison to open laparotomy; a case report and review of the literature

Obesity and gynecologic surgery via minimally invasive surgery with comparison to open laparotomy; a case report and review of the literature

Obesity: A Risk Factor for Infection after Surgery

Combined Approach to Surgical Treatment of Endometrial Cancer in Patients With Morbid Obesity

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