Field Xavier, French Rowan
Department of General Surgery, Taranaki Base Hospital, New Plymouth, New Zealand.
Department of General Surgery, Waikato Hospital, Hamilton, New Zealand.
J Metab Bariatr Surg. 2024 Jun;13(1):34-38. doi: 10.17476/jmbs.2024.13.1.34. Epub 2024 Jun 18.
Traumatic lower limb amputation has been identified as a major risk factor for obesity and metabolic diseases. Surgery in amputees with obesity poses significant complexities with physical and logistical issues of positioning and ergonomics. A 64-year-old gentleman with a history bilateral above knee amputation, obesity, type 2 diabetes mellitus, and obstructive sleep apnea was worked up for bariatric surgery. Due to his amputations, it was unknown whether this would be safe or feasible. In order to ensure this, the patient was brought to the operating room more than a week in advance to trial positioning. The patient was able to be positioned in reverse Trendelenburg with straps across his lower chest and his proximal thighs. Despite obesity being a prevalent and increasing issue facing lower limb amputees, there was relative paucity of literature on the topic. The successful use of this strategy to position a bilateral amputee could be mirrored in future cases.
创伤性下肢截肢已被确定为肥胖和代谢性疾病的主要危险因素。肥胖截肢患者的手术在身体定位和人体工程学的物理及后勤问题上存在显著复杂性。一名64岁男性,有双侧膝上截肢史、肥胖、2型糖尿病和阻塞性睡眠呼吸暂停,接受了减肥手术评估。由于他的截肢情况,尚不清楚这样做是否安全或可行。为了确保这一点,患者提前一周多被带到手术室进行定位试验。患者能够采用头低脚高位,用绑带横跨其下胸部和近端大腿进行定位。尽管肥胖是下肢截肢患者面临的一个普遍且日益严重的问题,但关于该主题的文献相对较少。这种为双侧截肢患者定位的成功策略可在未来病例中得到借鉴。