Abstract

To assess the safety and efficacy of different insufflation methods in morbidly obese women undergoing laparoscopy. Retrospective analysis of 13 years' experience (Canadian Task Force classification II-2). University-affiliated hospital. One hundred thirty-eight morbidly obese women (weight >250 lbs, body mass index >36). The heaviest patient weighed 400 lbs and had a body mass index of 66. Laparoscopic tubal sterilizations and diagnostic laparoscopies performed on an outpatient basis by residents under faculty supervision. Of 138 patients, 36 underwent standard transumbilical insufflation with 5 failures, 83 had transuterine insufflation with 3 failures, 12 had subcostal insufflation with 1 failure, and 7 had open laparoscopy with 2 failures. The insufflation failure rate was significantly high for transumbilical insufflation and open laparoscopy, and not for transuterine or subcostal insufflation. Morbid obesity was not a contraindication to laparoscopy. (J Am Assoc Gynecol Laparosc 6(3):307-312, 1999)

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