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Alternative sites for laparoscopic cholecystectomy, in thin and obese patients from the point of view of changes in the abdominal dimensions

Advances in Social Sciences Research Journal

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Title Alternative sites for laparoscopic cholecystectomy, in thin and obese patients from the point of view of changes in the abdominal dimensions
 
Creator Ahmed, Hiwa Omer
 
Subject —
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Description Background: Laparoscopic cholecystectomy is the standard operation for treatment of gallstone disease, which is difficult in obese patients, but narrow abdomen and thin patients are also a challenge, resulting in complications which mainly affect patients at the extreme ends of the weight spectrum. This represents a major source of morbidity and mortality from laparoscopic procedures; the majority (80%) of these complications is due to placement of the primary trocar,Searching for techniques to prevent involuntary injuries must be put as the priority, to ensure the optimal retraction, allows enough space available for manipulation of the active jaws of the laparoscopic graspers or scissors. Aim: To define alternative sites for laparoscopic cholecystectomy, in thin and obese patients from the point of view of alteration in the abdominal dimensions, which may reduces laparoscopic, related injury. Methods: In Al Sulaimaniyah Teaching Hospital and Hatwan Private Hospitral , from (July 15th 2004-July14th 2009) 1076 patients underwent laparoscopic cholecystectomy by same team and 35% of them by the same surgeon. Standard 4 ports were used, with first entry port in the periumblical region. Sixty patients were selected, because of their extreme weight and the patients were classified accordingly in to two groups:Group A:had downward displacement of umbilicus (43-60 cm width & 30-45cm height of the abdomen).Group B; had narrow abdominal dimensions (28-38 cm width & 14-27cm height of the abdomen).Results: Different alternative sites for trocar insertion were selected in order to overcome abdominal thickness and discrepancy between length of the hand instruments and distance of the port to the gall bladderConclusions: We recommend using this principle in the patients with extreme weight and narrow abdomen when XU is less than 15 cm or (more than 25cm), to decrease challenges of sequel of laparoscopic cholecystectomy in these groups of patients.
 
Publisher Advances in Social Sciences Research Journal
 
Contributor —
 
Date 2015-12-28
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
 
Format application/pdf
 
Identifier http://www.scholarpublishing.org/index.php/ASSRJ/article/view/1554
10.14738/assrj.212.1554
 
Source Advances in Social Sciences Research Journal; Vol 2, No 12 (2015): Advances in Social Sciences Research Journal
10.14738/assrj.212.2015
 
Language eng
 
Relation http://www.scholarpublishing.org/index.php/ASSRJ/article/view/1554/pdf_276