title: Obesity in laparoscopic surgery.
abstract: Since the 1980s, minimally invasive techniques have been applied to an increasing number and variety of surgical procedures with a gradual increase in the complexity of procedures being successfully performed laparoscopically. In the past, obesity was considered a contraindication to laparoscopy due to the higher risk of co-morbid conditions such as diabetes, hypertension, coronary artery disease and venous thromboembolism. Performing laparoscopic gynaecological procedures in morbidly obese patients is no longer a rare phenomenon; however, it does necessitate changes in clinical practice patterns. Understanding of the physiological changes induced by laparoscopy, particularly in obese patients, is important so that these may be counteracted and adverse outcomes avoided. Laparoscopy in obese patients confers certain advantages such as shorter hospital stay, less post-operative pain and fewer wound infections. In addition to these benefits, minimal-access surgery has been demonstrated as safe and effective in obese patients; however, specific surgical strategies and operative techniques may need to be adopted.
authors.affiliation: Specialist Registrar at King's College Hospital NHS Trust, Denmark Hill, London SE5 9RS, UK. Electronic address: drkafors@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Afors
authors.affiliation: Institut de Recherche Contre les Cancers de l'Appareil Digestif, Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Centini
authors.affiliation: Institut de Recherche Contre les Cancers de l'Appareil Digestif, Strasbourg, France.
authors.forename: R
authors.initials: R
authors.lastname: Murtada
authors.affiliation: Institut de Recherche Contre les Cancers de l'Appareil Digestif, Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Castellano
authors.affiliation: Institut de Recherche Contre les Cancers de l'Appareil Digestif, Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Meza
authors.affiliation: Head of Gynaecology Department, Strasbourg University Hospital, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Wattiez
mesh_terms: D005260:Female; D005831:Genital Diseases, Female / Q000150:complications / Q000601:surgery; D005833:Genital Neoplasms, Female / Q000150:complications / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D009765:Obesity / Q000150:complications; D009767:Obesity, Morbid / Q000150:complications*; D010149:Postoperative Pain; D056888:Patient Positioning / Q000379:methods; D011028:Pneumoperitoneum, Artificial / Q000379:methods; D011183:Postoperative Complications; D013530:Surgical Wound Infection
keywords: BMI; complications; gynaecological malignancies; laparoscopy; obesity; physiology