Post-operative course after conventional or laparoscopic gastroplasty in morbidly obese patients

Effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in morbidly obese patients receiving laparoscopic gastric banding

“…A major shortcoming of this investigation is the lack of an adequate control group, receiving gastric banding with the laparotomic approach, in order to differentiate those changes induced by anaesthesia from those related to the laparoscopic technique. However, previous investigations have demonstrated that laparoscopic placement of silicone‐adjustable gastric banding was as effective as the laparotomic procedure, but was less invasive and improved the perioperative outcome [3,4,12–14]. For this reason, the inclusion of a control group with the laparotomic procedure was judged not ethical both by the surgical staff and the Ethics Committee.…”

“…The laparoscopic technique has become a routine approach for a large number of surgical procedures, since it causes less postoperative pain, shortens hospital stay and allows patients to return to normal life more quickly than conventional laparotomic techniques [1–3]. At our Institution, laparoscopic procedures are currently performed in morbidly obese patients for laparoscopic gastric banding, which has been demonstrated to be associated with a lower perioperative morbidity and mortality than the laparotomic approach [3,4].…”

Anesthésie-réanimation chez l’obèse

“…Les bénéfices postopératoires attendus de la laparoscopie par rapport à la laparotomie ont été confirmés dans le cadre de la gastroplastie de l'obèse : moindre consommation d'antalgiques, déambulation plus précoce, durée d'hospitalisation raccourcie [46]. Ces bénéfices potentiels doivent être mis en balance avec les contraintes du pneumopéritoine peropératoire.…”

Anesthesia in the obese patient: Pharmacokinetic considerations

“…Morbidly obese patients are more prone to develop diabetes, respiratory failure, hypertension, left ventricular (LV) hypertrophy, atherosclerosis, myocardial ischemia [8][9][10], and some forms of cancer than nonobese patients [11]. Obesity is also associated with several surgical pathologies [1], whereas the development of laparoscopic techniques has further increased the indication to surgical treatment of obesity, causing less postoperative pain, shorter hospital stay, and faster return to normal life as compared with conventional laparotomic techniques [12][13][14]. For these reasons, obese patients are presenting more and more frequently for surgical procedures [15].…”