The Effect of Age and Body Mass Index on the Surgical Anatomy of Supraumbilical Port Insertion: Implications for Laparoscopic and Robotic Surgery.

Published

Journal Article

BACKGROUND:Minimally invasive surgery is the preferred approach for performing many gynecologic procedures. Occasionally, supraumbilical port placement may be preferable to optimize visibility and maneuverability although the risks of complications are less well characterized compared to umbilical entry. METHODS:We conducted a retrospective review of computed tomograms from 92 patients to evaluate the anatomic considerations for umbilical and supraumbilical port entry based on patient age, body mass index (BMI), parity, abdominal wall thickness, and distance to the great vessels. RESULTS:Supraumbilical entry was not associated with differences in distance to the great vessels compared to the umbilicus. However, supraumbilical location and BMI were associated with greater abdominal wall thickness. Age and BMI were associated with greater distance to the great vessels, while age was associated with thinner abdominal wall. Multiple linear regression confirmed independent effects of age and BMI. No association between parity and distance to retroperitoneal vessels was observed. CONCLUSION:Younger patients may be at increased risk for great vessel injury and pre-peritoneal insufflation. Obese patients may be at risk for pre-peritoneal insufflation, while patients with BMI < 30, particularly with a skin-to-aorta distance < 7 cm, may be at an increased risk for great vessel injury. Surgeons should consider these factors when considering supraumbilical port entry.

Full Text

Duke Authors

Cited Authors

  • Bedaiwy, MA; Yong, PJ; Farghaly, TA; Abdelhafez, FF; Tan, J; Pope, R; Hurd, WW; Liu, JH; Zanotti, K

Published Date

  • January 2018

Published In

Volume / Issue

  • 83 / 6

Start / End Page

  • 546 - 551

PubMed ID

  • 29705775

Pubmed Central ID

  • 29705775

Electronic International Standard Serial Number (EISSN)

  • 1423-002X

International Standard Serial Number (ISSN)

  • 0378-7346

Digital Object Identifier (DOI)

  • 10.1159/000488676

Language

  • eng