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Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery

BACKGROUND: The effects of the patient’s body position on the intraabdominal workspace in laparoscopic surgery were analyzed. METHODS: The inflated volume of carbon dioxide was measured after insufflation to a preset pressure of 15 mmHg for 20 patients with a body mass index (BMI) greater than 35 kg...

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Autores principales: Mulier, Jan Paul J., Dillemans, Bruno, Van Cauwenberge, Sebastiaan
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869437/
https://www.ncbi.nlm.nih.gov/pubmed/20054583
http://dx.doi.org/10.1007/s00464-009-0785-8
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author Mulier, Jan Paul J.
Dillemans, Bruno
Van Cauwenberge, Sebastiaan
author_facet Mulier, Jan Paul J.
Dillemans, Bruno
Van Cauwenberge, Sebastiaan
author_sort Mulier, Jan Paul J.
collection PubMed
description BACKGROUND: The effects of the patient’s body position on the intraabdominal workspace in laparoscopic surgery were analyzed. METHODS: The inflated volume of carbon dioxide was measured after insufflation to a preset pressure of 15 mmHg for 20 patients with a body mass index (BMI) greater than 35 kg/m(2). The patients were anesthetized with full muscle relaxation. The five positions were (1) table horizontal with the legs flat (supine position), (2) table in 20° reverse Trendelenburg with the legs flat, (3) table in 20° reverse Trendelenburg with the legs flexed 45° upward at the hips (beach chair position), (4) table horizontal with the legs flexed 45° upward at the hips, and (5) table in 20° Trendelenburg with the legs flat. The positions were performed in a random order, and the first position was repeated after the last measurement. Repeated measure analysis of variance was used to compare inflated volumes among the five positions. RESULTS: A significant difference in inflated volume was found between the five body positions (P = 0.042). Compared with the mean inflated volume for the supine position (3.22 ± 0.78 l), the mean inflated volume increased by 900 ml for the Trendelenburg position or when the legs were flexed at the hips, and decreased by 230 ml for the reverse Trendelenburg position. CONCLUSIONS: The Trendelenburg position for lower abdominal surgery and reverse Trendelenburg with flexing of the legs at the hips for upper abdominal surgery effectively improved the workspace in obese patients, even with full muscle relaxation.
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spelling pubmed-28694372010-05-24 Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery Mulier, Jan Paul J. Dillemans, Bruno Van Cauwenberge, Sebastiaan Surg Endosc Article BACKGROUND: The effects of the patient’s body position on the intraabdominal workspace in laparoscopic surgery were analyzed. METHODS: The inflated volume of carbon dioxide was measured after insufflation to a preset pressure of 15 mmHg for 20 patients with a body mass index (BMI) greater than 35 kg/m(2). The patients were anesthetized with full muscle relaxation. The five positions were (1) table horizontal with the legs flat (supine position), (2) table in 20° reverse Trendelenburg with the legs flat, (3) table in 20° reverse Trendelenburg with the legs flexed 45° upward at the hips (beach chair position), (4) table horizontal with the legs flexed 45° upward at the hips, and (5) table in 20° Trendelenburg with the legs flat. The positions were performed in a random order, and the first position was repeated after the last measurement. Repeated measure analysis of variance was used to compare inflated volumes among the five positions. RESULTS: A significant difference in inflated volume was found between the five body positions (P = 0.042). Compared with the mean inflated volume for the supine position (3.22 ± 0.78 l), the mean inflated volume increased by 900 ml for the Trendelenburg position or when the legs were flexed at the hips, and decreased by 230 ml for the reverse Trendelenburg position. CONCLUSIONS: The Trendelenburg position for lower abdominal surgery and reverse Trendelenburg with flexing of the legs at the hips for upper abdominal surgery effectively improved the workspace in obese patients, even with full muscle relaxation. Springer-Verlag 2010-01-07 2010 /pmc/articles/PMC2869437/ /pubmed/20054583 http://dx.doi.org/10.1007/s00464-009-0785-8 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Mulier, Jan Paul J.
Dillemans, Bruno
Van Cauwenberge, Sebastiaan
Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title_full Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title_fullStr Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title_full_unstemmed Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title_short Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
title_sort impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869437/
https://www.ncbi.nlm.nih.gov/pubmed/20054583
http://dx.doi.org/10.1007/s00464-009-0785-8
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