8842 Optimizing Trocar Placement in Gynecologic Surgery for the Obese Patient: A Systematic Review and Meta-Analysis

Abstract

<h3>Study Objective</h3> Obesity, as defined as a BMI of greater than 30 kg/m2, has been associated with increased surgical risk and increased technical difficulty. Many studies have evaluated ways of combating these challenges, including patient positioning and abdominal entry, however little has been reported in regard to ancillary trocar insertion site and techniques. This systematic review and meta-analysis aim to answer the question, what is the optimal trocar placement in the obese patient? <h3>Design</h3> A systematic review will be conducted using the following databases: Embase, Cochrane, Medline and Pubmed. <h3>Setting</h3> Clinical trials, randomized control trials, retrospective cohort studies and systematic reviews will be analyzed. <h3>Patients or Participants</h3> Women who have undergone laparoscopic surgery with a BMI of 30 kg/m2 or greater. <h3>Interventions</h3> Outcomes following laparoscopic gynecologic surgery related to trocar placement in the obese patient will be evaluated. <h3>Measurements and Main Results</h3> Statistical analysis will be performed using comprehensive meta-analysis software. Outcomes to be compared and evaluated will include successful surgery, complications such as vascular or bowel injury, unsuccessful trocar placement, conversion to open, wound infection, and operative time. Complete review and meta-analysis to be completed by August 2022. <h3>Conclusion</h3> Laparoscopic surgery in the obese patient has been known to have increased surgical risks and technical challenges. By determining the optimal trocar placement in the obese patient, we can improve surgical ergonomics, as well as the laparoscopic safety profile for this population.