Poindexter A N, Ritter M, Fahim A, Humphrey H
Surg Gynecol Obstet. 1987 Jul;165(1):57-9.
Obesity, especially morbid obesity, is reported to be a relative contraindication to laparoscopy. A technique for trocar introduction and laparoscopy of the obese patient to eliminate this contraindication is described. The technique presented herein differs from the traditional method by: 1, primary trocar entry at a 90 degree angle to the horizontal plane, and 2, confirmation for intraperitoneal position of the instruments before creating the pneumoperitoneum. A retrospective study was done to compare demographic, medical and surgical data of obese and non-obese patients. No important differences were found and it was also found that obesity was not a relative contraindication to laparoscopy. Obesity was defined by a ponderal index of less than 11.7. No operative complications were found for the 344 obese patients studied and all laparoscopy procedures were completed as intended. These differences in technique can avoid the pitfalls commonly reported concerning laparoscopy of the obese patient.
据报道，肥胖尤其是病态肥胖是腹腔镜检查的相对禁忌证。本文描述了一种用于肥胖患者套管针置入和腹腔镜检查的技术，以消除这一禁忌证。本文介绍的技术与传统方法的不同之处在于：1. 主套管针与水平面呈90度角进入；2. 在建立气腹之前确认器械在腹腔内的位置。进行了一项回顾性研究，比较肥胖和非肥胖患者的人口统计学、医学和手术数据。未发现重要差异，还发现肥胖并非腹腔镜检查的相对禁忌证。肥胖的定义为体质指数小于11.7。在研究的344例肥胖患者中未发现手术并发症，所有腹腔镜手术均按计划完成。这些技术差异可避免肥胖患者腹腔镜检查中常见的陷阱。
