Abstract: Laparoscopy in morbidly obese patients.

Authors:

Pasic R, Levine RL, Wolf WM Jr.

Institution:

Department of Obstetrics and Gynecology, University of Louisville, School of Medicine, 550 South Jackson Street, Louisville KY 40202, USA.

Source:

J Am Assoc Gynecol Laparosc. 1999 Aug;6(3):307-12.

Abstract:

STUDY OBJECTIVE: To assess the safety and efficacy of different insufflation methods in morbidly obese women undergoing laparoscopy. DESIGN: Retrospective analysis of 13 years' experience (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: One hundred thirty-eight morbidly obese women (weight >250 lbs, body mass index >36). The heaviest patient weighed 400 lbs and had a body mass index of 66. INTERVENTION: Laparoscopic tubal sterilizations and diagnostic laparoscopies performed on an outpatient basis by residents under faculty supervision. MEASUREMENTS AND MAIN RESULTS: Of 138 patients, 36 underwent standard transumbilical insufflation with 5 failures, 83 had transuterine insufflation with 3 failures, 12 had subcostal insufflation with 1 failure, and 7 had open laparoscopy with 2 failures. CONCLUSION: The insufflation failure rate was significantly high for transumbilical insufflation and open laparoscopy, and not for transuterine or subcostal insufflation. Morbid obesity was not a contraindication to laparoscopy.

Keywords:

Gynaecology Surgery Laparoscopy BMI Complications Obesity