scholarly journals Perioperative ventilatory strategies for improving arterial oxygenation and respiratory mechanics in morbidly obese patients undergoing laparoscopic bariatric surgery

2012 ◽  
Vol 28 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Khaled M. El-Sayed ◽  
Mohamed M. Tawfeek
Keyword(s):  
Bariatric Surgery ◽  
Respiratory Mechanics ◽  
Morbidly Obese ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
Arterial Oxygenation

scholarly journals The Influences of three Intraoperative Ventilatory Strategies on Arterial Oxygenation in Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery

2021 ◽  
pp. 1-16
Author(s):  
Shaimaa E. Shaban ◽  
Reda S. Salama ◽  
Mohamed M. Abu Elyazed ◽  
Abdelraheem M. Dowidar
Keyword(s):  
Bariatric Surgery ◽  
Cardiac Output ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Conventional Ventilation ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
Arterial Oxygenation ◽  
Morbid Obese ◽  
The Mean

Background: Maintaining satisfactory ventilation for obese patients undergoing bariatric surgery frequently poses a challenge for anesthetists. The optimal ventilation strategy during pneumoperitoneum remains obscure in obese patients. In this study, we investigated the effect of conventional ventilation, inverse ratio ventilation (IRV) and alveolar recruitment maneuver (RM) on arterial oxygenation, lung mechanics and hemodynamics in morbid obese patients undergoing laparoscopic bariatric surgery. Methods: 105 adult obese patients scheduled for elective laparoscopic bariatric surgery were randomly allocated into three groups: Conventional ratio ventilation (I:E ratio was 1:2, PEEP 5 cmH2O and no RM), Inverse Ratio Group (IRVG) (I:E ratio was 2:1 and PEEP 5 cmH2O and No RM ) and Recruitment Maneuver Group (RMG) ( RM was done and I:E ratio was 1:2). Arterial blood gases and respiratory mechanics were recorded after induction of anesthesia (T1), 5 minutes (T2), 30 minutes (T3), 60 minutes (T4) after the beginning of pneumoperitoneum and at the end of the surgery (T5).  Cardiac output was recorded at (T1), (T2), (T3) and (T5). Results: At T3, T4 and T5, arterial oxygen tension was higher in RMG than IRVG than CG (P ˂ 0.05). At T3, T4 and T5, the mean airway pressure and dynamic compliance (Cdyn) were significantly higher in IRVG and RMG compared with CG (P ˂ 0.05) while at those times, the mean air way pressure and Cdyn in IRVG and RMG were comparable. Cardiac output result were comparable between all groups throughout the study period (P ˃ 0.05). Conclusions: RM and IRV had provided better arterial oxygenation and respiratory mechanics compared to conventional ventilation in morbid obese patients undergoing laparoscopic bariatric surgery. However, RM had better gas exchange than IRV.

scholarly journals Outcome of Anticoagulant Therapy Following Bariatric Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Yousef ◽  
A F Mohamed ◽  
B H Elshayeb ◽  
G M Abdelmalak
Keyword(s):  
Bariatric Surgery ◽  
Effective Means ◽  
Cost Benefit ◽  
Morbidly Obese ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
University Hospitals ◽  
Coagulation Therapy ◽  
Anticoagulant Drugs ◽  
Significant Difference

Abstract Background Bariatric surgery remains the most effective means of treating severe obesity. The number of severely obese patients is increasing and, consequently, more people are seeking bariatric surgery. Aim of the Work The Aim of This Study is to Outcome of Anticoagulant during Bariatric Surgery and Relation of Bariatric Surgery to Coagulopathy Disease. Patients and Methods This prospective study was conducted on 50 morbidly obese patients admitted to Hospital (Ahmed Maher Teaching Hospital and Ain Shams University Hospitals), for a primary one-stage laparoscopic bariatric surgery procedure over a 6-month period. The study is performed on 50 Patients, Who met all Inclusion criteria and none of Exclusion criteria. Results The study revealed no statistically significant difference between Enoxaparin and Rivaroxaban according to outcome of anti-coagulation therapy following bariatric surgery. Conclusion a high protective value of Chemical Thromboprophylaxis combined to Mechanical Thromboprophylaxis in preventing DVT safely. New Oral Anticoagulant drugs showed equal and may be superimposed the other traditional anticoagulant, but it needs more studies regarding its prophylactic dose, number of patient and its cost benefit in comparison with other Anticoagulant drugs were used in our study or other studies we mentioned above.

Direct Trocar Insertion with Elevation of the Rectus Sheath in Bariatric Surgery: A Novel Technique

2017 ◽  
Vol 89 (6) ◽  
pp. 23-25
Author(s):  
Mani Habibi ◽  
Hakan Seyit ◽  
Osman Kones ◽  
Bahadir Kartal ◽  
Halil Alis
Keyword(s):  
Bariatric Surgery ◽  
Laparoscopic Surgery ◽  
Rectus Sheath ◽  
Morbidly Obese ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
Trocar Insertion ◽  
Trocar Placement ◽  
Direct Trocar Insertion ◽  
Almost All

<b>Introduction.</b> Initial trocar entry, the first step in laparoscopic surgery, is associated with several complications. In morbidly obese patients, initial trocar placement is associated with a greater number of complications compared to non-obese patients. <br/><b>Materials and Surgical Technique</b>. In this study, we describe our use of an initial trocar entry technique which is direct trocar insertion with elevation of the rectus sheath by a single Backhaus towel clamp and we would like to evaluate the sa fety and efficacy of its administration in bariatric surgery. <br/><b>Discussion</b>. Our results indicate that gaining initial trocar entry using our technique leads to successful laparoscopic bariatric surgery. Our technique is a safe, effective, and reliable first step in successful laparoscopic surgery for almost all patients, and is only contraindicated in patients with severe hepatomegaly.

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