The spinal needle test effectively measures abdominal wall thickness before cannula placement at laparoscopy

Area of Science:

• Minimally Invasive Surgery
• Surgical Anatomy
• Obesity Medicine

Background:

• Accurate estimation of abdominal wall thickness is crucial for safe laparoscopic entry.
• Body Mass Index (BMI) is a key indicator of patient adiposity, influencing surgical site characteristics.

Purpose of the Study:

• To evaluate the utility of the spinal needle test during laparoscopy.
• To establish the correlation between abdominal wall thickness at entry sites and patient BMI.

Main Methods:

• Prospective cohort study involving 138 women undergoing diagnostic laparoscopy.
• Abdominal wall thickness was measured using a spinal needle test at the umbilicus and left upper quadrant after CO(2) insufflation.
• Correlation analysis was performed between thickness measurements and Body Mass Index (BMI).

Main Results:

• Significant correlations were observed between BMI and abdominal wall thickness at both the umbilicus (R=0.69) and left upper quadrant (R=0.81).
• Body weight also showed excellent correlation with thickness at both sites (R=0.72 and R=0.78).
• Obese women exhibited significantly greater mean abdominal wall thickness compared to non-obese women at both measurement sites (p <0.001).

Conclusions:

• Abdominal wall thickness at standard laparoscopic entry sites correlates strongly with patient weight and BMI.
• The spinal needle test provides a reliable method for assessing abdominal wall thickness, even in obese individuals.
• This technique aids in predicting safe entry depths during laparoscopy.