Laparoscopy in morbidly obese patients.
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)
Pasic
R
R
Department of Obstetrics and Gynecology, University of Louisville, School of Medicine, 550 South Jackson Street, Louisville KY 40202, USA.
Levine
R L
RL
Wolf
W M
WM
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