From the Journals

Single-port laparoscopy has few complications but BMI matters


AT AAGL 2017

– Single-port laparoscopy is both safe and feasible, and has the potential to decrease surgical complications and increase efficiency, according to findings presented at the AAGL Global Congress.

Ahmed N. Al-Niaimi, MD, of the University of Wisconsin–Madison, and his colleagues, conducted a retrospective cohort study analyzing 587 consecutive patients who underwent single-port laparoscopy from March 2012 to December 2016. Of the 587 patients, there were 27 clinically-relevant complications among 18 patients (3%). The complications included intensive care unit admission, reoperation, end organ damage, organ space surgical site infection, and readmission.

Dr. Ahmed Al-Niaimi of the University of Wisconsin–Madison

Dr. Ahmed Al-Niaimi

“Those factors leading to those complications are similar to the factors that cause complications in any other surgery,” Dr. Al-Niaimi said in an interview before the meeting.

Body mass index was found to be a primary contributor to surgical complications. Patients with a BMI of more than 30 kg/m2 experienced a 1% increase in the risk of surgical complications per unit value increase of BMI. This is significant because the median BMI of the patient population in the study was 33.9 kg/m2 and 57% of the study participants were considered obese or morbidly obese.

“The heavier the patient, the higher the complication rate,” Dr. Al-Niaimi said.

Surgeons who are learning single-port laparoscopy should choose patients with lower BMIs to gain efficiency in using the new technique, Dr. Al-Niaimi suggested. This will allow patients to decrease their risk of surgical complications while allowing surgeons to hone their abilities in a new surgical technique, he said.

The other prime contributor to surgical complications is the length of surgical time. The average time of surgery during the study was 156 minutes. Dr. Al-Niaimi and his colleagues found that for each 10-minute increase in surgical time, the risk of complications increased by 2%.

While the results of the study demonstrate safety in the single-port approach, Dr. Al-Niaimi said a randomized controlled trial is needed to validate the findings and determine whether single-port laparoscopy is more effective than multi-port laparoscopy.

Dr. Al-Niaimi reported having no financial disclosures.

Recommended Reading

Postsurgical antibiotics cut infection in obese women after C-section
MDedge Surgery
VIDEO: Researchers beginning to explore microbiome’s effect on surgical outcomes
MDedge Surgery
Some measures to control HAI sound better than they perform
MDedge Surgery
Strict OR attire policy had no impact on SSI rate
MDedge Surgery
Type of headwear worn during surgery had no impact on SSI rates
MDedge Surgery