title: Laparoscopy in morbidly obese patients.
abstract: OBJECTIVE
  To assess the safety and efficacy of different insufflation methods in morbidly obese women undergoing laparoscopy.
  
  
  METHODS
  Retrospective analysis of 13 years' experience (Canadian Task Force classification II-2).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  Laparoscopic tubal sterilizations and diagnostic laparoscopies performed on an outpatient basis by residents under faculty supervision.
  
  
  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.
  
  
  CONCLUSIONS
  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. (J Am Assoc Gynecol Laparosc 6(3):307-312, 1999)
authors.affiliation: Department of Obstetrics and Gynecology, University of Louisville, School of Medicine, 550 South Jackson Street, Louisville KY 40202, USA.
authors.forename: R
authors.initials: R
authors.lastname: Pasic
authors.forename: R L
authors.initials: RL
authors.lastname: Levine
authors.forename: W M
authors.initials: WM
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome