Proposal to standardize the first puncture in Morbid Obesity Surgery, according to anthropometry
DOI:
https://doi.org/10.33448/rsd-v14i2.48326Keywords:
Gastric bypass; Surgery; Morbid obesity; Anthropometry.Abstract
The objective is to identify the best point for the first puncture, seek to systematize the operation for morbid obesity,and evaluate the anatomical repairs and anthropometric data. In methodology, a prospective, longitudinal quantitative observational study was carried out for 2 years in obese patients with the same surgeon in hospitals in Rio de Janeiro, previously studied and released by a multidisciplinary team. All patients were submitted and asked for informed consent. Patients were selected with a grade III obesity body mass index, included in a questionnaire, with specific data, and measured by the same surgeon. The main and analyzed data were sex, age, BMI, anthropometric measurements such as xiphoid measurement, assessment of the Charpy angle in degrees, and distance from the umbilical scar to the possible puncture. These data were statistically analyzed to identify the best choice for the first puncture or placement of the first trocar. All patients underwent general anesthesia, in the supine position, with legs closed, and using the same technique, intending to visualize and manipulate the hiatus. Anthropometric study and BMI are important data before minimally invasive bariatric surgery, they become important in deciding the placement of the first chamber trocar for better visualization of the upper abdomen, facilitating the surgeon's work. This standardization according to anthropometry helps and facilitates the management of minimally invasive surgery.
References
ABESO. Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. Diretriz Brasileira de Obesidade. 4ª edição. São Paulo. 2016.
Andrade, S. C., Araújo, R. M.& Lara, D. R. (2017). Association of Weight Control Behaviors with Body Mass Index and Weight-Based Self-Evaluation. Revista Brasileira de Psiquiatria. 39(2), 237-43.
Araújo, G .B. et al. (2018). Perfil Clínico-Epidemiológico de Pacientes Submetidos à Cirurgia Bariátrica. Pará Research Medical Journal. (4), e38.http://dx.doi.org/10.4322/prmj.2017.038.
Balsiger, B. M. et al. (2000). Prospective evaluation of Roux-en-Y gastric bypass as primary operation of medically complicated obesity. Mayo Clin Proc. 75(7), 673-80.
Beaulac, J.& Sandre, D. (2017). Critical review of bariatric surgery, medically supervised diets, and behavioral interventions for weight management in adults. Perspect Public Health. 137(3), 162-72.
Björntorp, P. (2003). Definition and classification of obesity. In: Fairbuirn & Brownell (eds) Eating disorders and obesity. 2ed, New York, p. 377-81.
Bray, G. A. et al. (2016). Management of obesity. The Lancet. 7(10031), 1947-56.
Brolin, R. E. (1996). Update: NIH consensus conference. Gastrointestinal surgery for severe obesity. Nutrition 1996; 12: 403-4.
Capella, J. F. & Capella, R. F. (1996). The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg. 171, 74-7.
Calle, E. E. et al. (1999). Body mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 341, 1097-105.
Carvalho, T. S., Vasconcelos, F. C.& Carvalho, M .D. B. M. (2016). Análise do histórico de métodos de emagrecimento dos pacientes submetidos à Cirurgia Bariátrica em um hospital público de Belém-PA. Revista Brasileira de Obesidade, Nutrição e Emagrecimento. São Paulo. 10(55), 4-11.
Castro, M. R. et al. (2010). Cirurgia Bariátrica: a trajetória de mulheres obesas em busca de emagrecimento. HU Revista. Juiz de Fora. 36 (1), 29-36.
Cohen, R. V., Moreira, L. & Schiavon, C. A. (1994).Metabolic and systemic responses following interventional laparoscopy. Austin: Landes Publishers.
Coombs, A.V. (2024). Cirurgia. Manual MSD. Versão saúde para a família. https://www.msdmanuals.com/pt/casa/assuntos-especiais/cirurgia/cirurgia
Coutinho, W. (1999). Consenso Latino-Americano de Obesidade. Arq Bras Endocrinol Metab. 43, 21-67.
Doldi, S. B. et al. (2000). Adjustable gastric banding: 5-year experience. Obes Surg. 10, 171-173.
De La Torre, R. A. & Slot, J. S. (1999). Laparoscopic Roux-en-Y gastric bypass: a totally intra abdominal approach. Obes Surg. 9, 492-8.
Eskandaros M. (s.d.). Bypass gástrico laparoscópico de uma anastomose versus efeitos laparoscópicos do bypass gástrico em Y-de-Roux na doença de refluxo gastroesofágico leve a moderada pré-existente em pacientes com obesidade: um estudo controlado randomizado. ObesSurg.31(11), 4673-81.
Favreti F, Cadiere G B, Segato G et al. (1995). Laparoscopic adjustable silicone gastric banding: technique and results. Obes Surg 1995; 5, 364-371.
Fobi, M. A L, Lee H, Holness R, Cabinda D G. (1998). Gastric bypass operation for obesity. World J Surg 1998; 22, 925-935.
Franques. (2003). Sobre o Comportamento e cognição. In: Arruda RTC (ed) Obesidade mórbida e intervenção, ESETEC Editores Associados, pp. 335, 2003.
Higa, K. D. (2000). Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 135, 1029-34.
Hsu, L. K.et al. (1998). Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 60(3), 338-46.
Junges, V. M. et al. (2016). Perfil do paciente obeso e portador de síndrome metabólica candidato à cirurgia bariátrica em uma clínica particular de Porto Alegre, Rio Grande do Sul. Scientia Médica. Rio Grande do Sul. 26(3). 2016.
Kelly, T. et al. (2008). Global burden of obesity in 2005 and projections to 2030. Int JObes. 32(9),1431-7.
Khaodhiar, L.& Blackburn, G. L. (2001). Health benefits and risks of weight loss. In: Björntorp, P. (ed) International textbook of obesity, John Wiley & Sons, Chichester pp. 413-40.
Kron, I. L., Harman, P. K. & Nolan, S. P. (1984). The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg.199(1), 28-30.
MacLean, L. D. (1995). Surgery for obesity: an update of a randomized trial. Obesity Surger. 5, 145-153.
Mason, E. E. et al. (1998). Vertical gastroplasty: evolution of vertical band gastroplasty. World J Surg, 22, 919-24.
Nguyen, N. T. et al. (2002). Systemic stress response after laparoscopic and open gastric bypass. J Am Coll Surg. 194(5), 557-66; discussion 566-7.
Nguyen, N. T. et al. (2001a). Evaluation of intra-abdominal pressure after laparoscopic and open gastric bypass. Obes Surg. 11(1), 40-5.
Nguyen ,N. T. et al. (2001b). Comparison of pulmonary function and postoperative pain after laparoscopic versus open gastric bypass: a randomized trial. J Am Coll Surg.192(4), 469-76; discussion 476-7.
Nunes; A,; Abuchaim; C et al. (1998). Transtornos alimentares e obesidade, Edeitora ArtMed.
Pacheco, D., Pinto, P. & Asencio, E. (2019). Atualização em cirurgia bariátrica/metabólica. Nutric Clin Med. 2019;13(2), 113-27.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.
Pories, W. J.& Joseph, E. B. (2003). Surgery for obesity: procedures and weight loss. In: Fairbuirn & Brownell (eds) Eating disorders and obesity, (2ed). New York, pp. 562-7.
Pope, G. D., Birkmeyer, J. D. & Finlayson, S. R. (2002). National trends in utilization and inhospital outcomes of bariatric surgery. J Gastrointest Surg. 6(6), 855-60; discussion 861.
Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia. (2ed.). Editora Erica.
Toassi, R. F. C. & Petry, P. C. (2021). Metodologia científica aplicada à área da Saúde. (2. ed.). Editora da UFRGS.
Varella, D. & SBCBM. (2021). Cirurgia bariátrica (cirurgia de redução do estômago). https://bvsms.saude.gov.br/cirurgia-bariatica/.
Vieira, S. (2021). Introdução à bioestatística. Ed. GEN/Guanabara Koogan.
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Copyright (c) 2025 Cesar Bernardo Ortiz Villavicencio; Miguel Mateo Sarmiento Alvarez; Santiago Fernando Velez Loaiza; Jaime Andres Neira Verduga; Lorena Ribeiro Teixeira Gouveia; Gabrielle Vaz de Azevedo David; Guilherme Lemos Cotta Pereira
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