Patient-Related Factors Predicting Workspace Conditions during Laparoscopic Bariatric Surgery
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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.
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).
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).
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.
KeywordsLaparoscopic bariatric surgery Obese Patients-centered care Prediction Personalized medicine Surgeon satisfaction Workspace Deep neuromuscular block
Compliance with Ethical Standard
Conflict of Interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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