ABSTRACT
Laparoscopic surgery has become very popular for the treatment of severe obesity. Obesity can be distributed in either an android fashion, primarily within the abdominal area or centrally as seen primarily in male patients, or in a gynoid manner, in the hips and buttocks, peripherally as seen primarily in female patients. Many of our severely obese female patients have both peripheral and central obesity. We have found that central obesity is associated with a significant increase in intra-abdominal pressure and this pressure is as high or higher than the pressure seen in patients with an “acute abdominal compartment syndrome” (Fig. 5.1). Data support the finding that this increase in intra-abdominal pressure is associated with a number of obesity related co-morbidity problems leading to the development of a “chronic abdominal compartment syndrome”. These co-morbidities include obesity hypoventilation syn drome with its high cardiac filling pressures, gastroesophageal reflux disease, venous stasis disease, pseudotumor cerebri, an increased risk of incisional hernia and it is probably the cause of systemic hypertension and the nephrotic syndrome of obesity.
