The effect of patient body mass index on surgical difficulty in gynaecological laparoscopy

Introduction Over the past three decades, rates of overweight and obesity internationally have risen to epidemic proportions. There are currently no published prospective studies examining the effect of obesity on gynaecologic laparoscopy for benign indications within a population with obesity rates...

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Bibliographic Details
Published in:Australian & New Zealand journal of obstetrics & gynaecology 2014-12, Vol.54 (6), p.564-569
Main Authors: McIlwaine, Kate, Manwaring, Janine, Ellett, Lenore, Cameron, Melissa, Readman, Emma, Villegas, Rocio, Maher, Peter
Format: Article
Language:English
Subjects:
Adult
Anatomic Landmarks
Body Mass Index
complications
Conversion to Open Surgery
Female
Gynecologic Surgical Procedures - adverse effects
Gynecologic Surgical Procedures - methods
Humans
Ideal Body Weight
laparoscopic surgery
Laparoscopy - adverse effects
obesity
Obesity - complications
Prospective Studies
surgical outcomes
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Summary:Introduction Over the past three decades, rates of overweight and obesity internationally have risen to epidemic proportions. There are currently no published prospective studies examining the effect of obesity on gynaecologic laparoscopy for benign indications within a population with obesity rates comparable to Australian women. Aims To assess and quantify whether increasing patient body mass index negatively impacted upon the ability to successfully complete planned laparoscopic surgery. Methods From January 2009 until October 2012, 307 women undergoing laparoscopic gynaecological surgery for benign pathology were recruited. Intra‐operative variables included the following: ease of identification of anatomical landmarks, entry technique and number of attempts, conversion to laparotomy and any complications encountered. Any post‐operative complications were recorded at the six week post‐operative review. Results 94.46% of operations were completed as planned. As BMI increased, the ease of identification of important anatomical landmarks significantly decreased. There was no correlation between increasing BMI and surgical complication rates. Conclusions Planned gynaecological laparoscopy can be performed in obese patients with a high likelihood of completion. In this study, obesity was not associated with a significant increase in complication rates or failure to complete the surgery as planned.
ISSN:0004-8666
1479-828X
DOI:10.1111/ajo.12258