title: Hybrid approach of retractor-based and conventional laparoscopy enabling minimally invasive hysterectomy in a morbidly obese patient: case report and review of the literature.
abstract: Minimally invasive hysterectomy in obese patients may be limited by laparoscopic sight on the one hand and by intraoperative complications related to reduced ventilation due to pneumoperitoneum on the other. Retractor-based laparoscopy offers an operative technique reducing anesthesia risks. We report the case of laparoscopic hysterectomy in an obese patient of short stature. Laparoscopic supracervical hysterectomy was performed by a hybrid approach of a retractor system exerting its effects on lifting the abdominal wall through gravity and conventional laparoscopy, thus bypassing the adverse effects of pneumoperitoneum on ventilation.
authors: Department of Gynecology and Ostetrics, University Hospital Schleswig Holstein , Campus Luebeck, Luebeck , Germany.
authors: Friederike
authors: F
authors: Hoellen
authors: Achim
authors: A
authors: Rody
authors: Andrea
authors: A
authors: Ros
authors: Angela
authors: A
authors: Bruns
authors: Christoph
authors: C
authors: Cirkel
authors: Michael K
authors: MK
authors: Bohlmann
mesh_terms: D034861:Abdominal Wall; D001827:Body Height / Q000502:physiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009767:Obesity, Morbid / Q000150:complications*
keywords: Gasless laparoscopy; hysterectomy; obesity; pneumoperitoneum; retractor system