Ideal Patients Body Position for Bariatric Surgery

1
Ideal Patients Body Position for Bariatric
Surgery

• Mulier J.P. 1, Dillemans B.2, Van Cauwenberge
  S.2,Lesaffer J. 2 Casier I. 1
• 1. Dep of Anesthesia, Sint JAN Brugge-Oostende,
  Bruges, Belgium.
• 2. Dep of general Surgery Sint JAN
  Brugge-Oostende, Bruges, Belgium, Belgium
• Contact Email jan.mulier_at_azbrugge.be
• More info www.publicationslist.com/jan.mulier

• Materials and Methods
• The pneumoperitoneum inflated volume at 15 mmHg
  was measured in 20 morbid obese patients
  undergoing laparoscopic surgery (and approved by
  the hospital ethical committee. )
• This measurement was taken with a) table
  horizontal, legs flat b) table in 20 reverse
  Trendelenburg, legs flat c) table in 20 reverse
  Trendelenburg, legs flexed 45 upward at the
  hips d) table horizontal, legs flexed 45
  upward and e) table in 20 Trendelenburg, legs
  flat.
• Trendelenburg is never used in upper abdominal
  laparoscopy but was also investigated.
• The inflated volume at 15 mmHg was measured for
  each position and an analysis of variance was
  performed on repeated measurements.
• References
• 1. Dillemans B. et al. Fully-Stapled Roux-enY
  gastric bypass. Obes Surg 2009
• 2. Mulier J. et al. On the abdominal pressure
  volume relationship. ISPUB 2009211

• Background and Goal of Study
• A sufficient laparoscopic workspace at a low
  abdominal pressure.
• What is the ideal patients body position to
  optimize workspace?
• Results

Conclusion In laparoscopic bariatric
surgery the legs should be flexed as much as
possible to maximize the surgical workspace in
anti trendelenburg position.
IFSO 26-29 aug 2009 Paris