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, Liliana Sollazzi

Research output: Contribution to journalArticle

Abstract

Background: Previous 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. Methods: One 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). Results: VNS 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). Conclusions: Findings 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.

Original languageEnglish
Pages (from-to)3172-3176
Number of pages5
JournalObesity Surgery
Volume28
Issue number10
DOIs
Publication statusPublished - Oct 1 2018

Keywords

  • Deep neuromuscular block
  • Laparoscopic bariatric surgery
  • Obese
  • Patients-centered care
  • Personalized medicine
  • Prediction
  • Surgeon satisfaction
  • Workspace

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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    Aceto, P., Modesti, C., Sacco, T., De Cicco, R., Perilli, V., Raffaelli, M., Lai, C., & Sollazzi, L. (2018). Patient-Related Factors Predicting Workspace Conditions during Laparoscopic Bariatric Surgery. Obesity Surgery, 28(10), 3172-3176. https://doi.org/10.1007/s11695-018-3295-8