• Obesity surgery · Oct 2018

    Patient-Related Factors Predicting Workspace Conditions during Laparoscopic Bariatric Surgery.

    • Paola Aceto, Cristina Modesti, Teresa Sacco, Roberto De Cicco, Valter Perilli, Marco Raffaelli, Carlo Lai, and Liliana Sollazzi.
    • Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. pa.aceto@gmail.com.
    • Obes Surg. 2018 Oct 1; 28 (10): 3172-3176.

    BackgroundPrevious studies have focused on the role of deep neuromuscular blockade (NMB) in improving surgical conditions during laparoscopic bariatric surgery. However, a wide inter-individual variability has been noted. The aim of this study was to identify patient-related factors affecting surgeon satisfaction with the surgical space and surgery duration in laparoscopic bariatric surgery under deep NMB.MethodsOne hundred eighty-five patients scheduled for laparoscopic gastric bypass were enrolled. Anesthesia was standardized. A deep NMB was maintained together with fixed patient positioning (30 reverse Trendelenburg) and constant pneumoperitoneum pressure (14 mmHg) during the whole surgical procedure. Immediately after surgery, the surgeon was invited to state his satisfaction with the surgical space through a verbal numeric scale (VNS) ranging from 0 (extremely poor) to 10 (optimal).ResultsVNS score was negatively correlated with male gender (r = - 0.35; p = 0.0001), BMI (r = - 0.16; p = 0.03), and age (r = - 0.20; p = 0.008). Surgery duration was positively correlated with male gender (r = 0.27; p = 0.0003) and BMI (r = 0.22; p = 0.006). Multivariate linear regressions showed that lower VNS scores were predicted by male gender (p = 0.000001) and increased age (p = 0.009), and that a longer surgery duration was predicted by male gender (p = 0.0002).ConclusionsFindings showed that male gender and higher patient age were independent predictors of lower surgeon satisfaction with the workspace during laparoscopic bariatric surgery. Male gender also had a significant role in predicting longer surgery duration. The role of android obesity, which is more frequently associated with male gender, in affecting surgeon-perceived workspace conditions needs further investigation.

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