Laparoscopic complications in markedly obese urologic patients (A multi-institutional review) - 11/09/11

Doi : 10.1016/S0090-4295(96)00231-2

David Mendoza ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Robert C. Newman ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m,^⁎, David Albala ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Marc S. Cohen ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Ashu Tewari ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, James Lingeman ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Michael Wong ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Louis Kavoussi ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, John Adams ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Robert Moore ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Howard Winfield ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, J. Matthew Glascock ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Sakti Das ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Larry Munch ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Michael Grasso ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Michael Dickinson ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Ralph Clayman ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Stephen Nakada ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Elspeth M. McDougall ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, I. Stuart Wolf ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, John Hulbert ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Raymond J. Leveillee ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, A. Houshair ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m, Culley Carson ^a,^b,^c,^d,^e,^f,^g,^h,^i,^k,^m
^a Department of Urology, University of Florida, Gainesville, Florida, USA
^b Department of Urology, Loyola University, Chicago, Illinois, USA
^c Department of Urology, GU Surgeons of Indiana, Indianapolis, Indiana, USA
^d Department of Urology, Johns Hopkins University, Baltimore,Maryland, USA
^e Department of Urology, University of Iowa, Iowa City, Iowa, USA
^f Department of Urology, KaiserPermanente, Walnut Creek, California, USA
^g Department of Urology, University of Kentucky, Lexington, Kentucky, USA
^h Department of Urology, Loma Linda University, Loma Linda, California, USA
ⁱ Department of Urology, Washington University, St. Louis, Missouri, USA
^k Department of Urology, Universityof Minnesota, Minneapolis, Minnesota, USA
^m Department of Urology, University of North Carolina, Chapel Hill, North Carolina, USA

^*Reprint requests: Robert C. Newman, M.D., Division of Urology, Univeristy of Florida, P.O. Box 100247, Gainesville, FL 32610-0247.

Abstract

Objectives. Significant obesity is considered to be a relative contraindication to laparoscopic surgery. This study reviews the complications encountered in massively obese patients undergoing urologic laparoscopic surgery.

Methods. Body mass index (BMI) was used as an objective index to indicate massive obesity. Eleven institutions compiled retrospective data on 125 patients having a BMI greater than 30. Procedures performed included 76 pelvic lymph node dissections, 14 nephrectomies, 7 bladder neck suspensions, and 28 miscellaneous procedures.

Results. For the group as a whole, the mean BMI was 35.1 (range 30.1 to 57.2). Mean operative time was 202 minutes (range 60 to 480). Conversion to open surgery occurred in 15 of the 125 patients (12%). Complication rates (minor and major) were 22% (27 occurrences in 125 patients) intraoperatively and 26% (33 occurrences in 125 patients) postoperatively. The major complications included 2 trocar injuries to abdominal wall vessels, 1 bladder injury, 3 peripheral nerve injuries, 1 dysrhythmia, 1 deep vein thrombosis, 1 wound seroma, 1 nephrocutaneous fistula, 1 incisional hernia, and 1 death.

Conclusions. In this review, complication rates for urologic laparoscopic surgery on massively obese patientswere higher than in the general population undergoing laparoscopic surgery (0.3% to 21%).

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Vol 48 - N° 4

P. 562-567 - octobre 1996 Retour au numéro

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Laparoscopic complications in markedly obese urologic patients (A multi-institutional review) - 11/09/11

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