Endo Yuichi, Takayama Hiroomi, Orimoto Hiroki, Nakamura Shun, Miyoshino Wataru, Nagasawa Yuiko, Kawano Yoko, Masuda Takashi, Hirashita Teijiro, Inomata Masafumi
Oita University, Ōita, Japan.
Obes Surg. 2025 Jun 2. doi: 10.1007/s11695-025-07931-4.
The global prevalence of obesity has risen significantly, thereby resulting in a consequential increase in the use of bariatric surgical procedures. Optical trocars are extensively utilized for identifying laparoscopic access in patients with morbid obesity. However, their efficacy and safety are dependent on the surgeon's capability to accurately identify anatomical structures during insertion. The current study investigated the influence of anatomical structure recognition and insertion time on successful optical trocar insertion, which can offer insights that are applicable to various surgical specialties.
This retrospective study was conducted on 143 patients who underwent laparoscopic sleeve gastrectomy. Data on demographic characteristics, comorbidities, anatomical structure recognition, and trocar insertion time were collected. To evaluate the associations between these factors, a statistical analysis using the univariate and multivariate models was performed.
The recognition of anatomical structures such as the rectus abdominis and peritoneum during the procedure was significantly related to shorter insertion times (p < 0.01). Multivariate analysis revealed that an accurate identification of these structures independently contributed to an efficient trocar placement. The risk of complications increased in cases where the peritoneum could not be clearly identified. However, there were no cases of major vascular or organ injuries, and all complications were managed with conservative treatment.
Successful trocar insertion in patients with morbid obesity is dependent on the precise recognition of anatomical structures, particularly the rectus abdominis and peritoneum. This approach enhances both procedural safety and efficiency, and the findings may have broader applicability to laparoscopic techniques.
全球肥胖患病率显著上升，导致减肥手术的使用相应增加。光学套管针广泛用于确定病态肥胖患者的腹腔镜入路。然而，其有效性和安全性取决于外科医生在插入过程中准确识别解剖结构的能力。本研究调查了解剖结构识别和插入时间对光学套管针成功插入的影响，可为各种外科专业提供适用的见解。
本回顾性研究对143例行腹腔镜袖状胃切除术的患者进行。收集了人口统计学特征、合并症、解剖结构识别和套管针插入时间的数据。为了评估这些因素之间的关联，进行了单变量和多变量模型的统计分析。
手术过程中对腹直肌和腹膜等解剖结构的识别与较短的插入时间显著相关（p < 0.01）。多变量分析显示，准确识别这些结构独立有助于高效放置套管针。在无法清晰识别腹膜的情况下，并发症风险增加。然而，没有发生重大血管或器官损伤的病例，所有并发症均采用保守治疗。
病态肥胖患者套管针的成功插入取决于对解剖结构的精确识别，特别是腹直肌和腹膜。这种方法提高了手术的安全性和效率，研究结果可能对腹腔镜技术具有更广泛的适用性。
