China News Service, July 16 (Chen Jing, Zheng Jiaqi) Obesity, especially severe obesity, has always been a relative contraindication for laparoscopic treatment.
The reporter learned on the 16th that a severely obese patient with polycystic ovary syndrome was successfully treated in Shanghai.
Experts from the International Peace Maternity and Child Health Hospital of the Chinese Welfare Association (National Women and Infants) successfully implemented single-port laparoscopic minimally invasive treatment for this female patient who is 169cm tall and weighs 300 kg.
Zhang Jian, an expert on women, infants and gynecology in China, said that the thick abdominal fat layer would greatly hinder the separation of the abdominal wall and organs.
"Patient Ms. Li has encountered this situation for the first time in my medical career."
"If surgery is performed, the fat layer of the abdomen may lead to poor postoperative incision recovery. Laparoscopic minimally invasive treatment, although difficult, but as long as it is handled properly, whether it is from the perspective of later recovery or from the perspective of meeting the needs of the patient, All are beneficial." Zhang Jian said.
Huang Yong, director of the Department of Women, Infants and Gynecology of China, led a multidisciplinary team to conduct detailed discussions on Ms. Li's condition. Based on the experience of thousands of laparoscopic operations carried out by the hospital in the past, two sets of treatment plans were formulated.
On the day of the operation, the surgical team composed of doctors specially selected an extended version of the surgical instrument, which was lengthened from 15cm to 18cm in order to better carry out laparoscopic treatment under the thick layer of fat.
Due to the fat and hypertrophy of Ms. Li's abdomen, the team of doctors failed to establish a pneumoperitoneum after repeated attempts.
The operation stalled for a while, and Zhang Jian made a decisive decision and decided to adopt the second plan: switch to looking directly at the umbilicus and enter the abdomen.
Through the umbilical single port laparoscopic surgery, only one incision is made, and all the laparoscopic lenses and instruments pass through this single small hole to complete the operation.
Compared with the multi-hole laparoscope, the surgical field of view is narrower and the instrument operation space is narrow.
In addition, severely obese patients have more fat in the abdominal cavity, which makes the limited operating space for doctors in single port surgery narrower, making the operation even more difficult.
According to reports, for Ms. Li, obesity is a high-risk factor for venous thrombosis. Once venous thrombosis occurs, it will pose a great threat to the patient's life.
Experts have carried out effective prevention and intervention of venous thrombosis.
After the operation, Ms. Li recovered well, exhausted at 3 hours after the operation, got up for 6 hours after the operation, and resumed normal activities one day after the operation, her vital signs were stable, and she was discharged from the hospital 2 days later.
The doctor told reporters that after the incision healed, scars were hardly seen.
The hospital told reporters that in recent years, the gynecological team of the hospital has extensively carried out single-port laparoscopic surgery for laparoscopic treatment of common gynecological diseases such as huge pelvic masses, uterine fibroids, and ovarian cysts. Compared with traditional laparoscopic surgery, because the incision is less and smaller, the patient feels less pain, postoperative adhesions and complications are relatively less, and postoperative recovery is faster and better. These advantages also bring new gospel to obese gynecological patients. (Finish)