Preoperative Ultrasound as a Predictor for Difficulty in Bariatric Surgery

Study Overview
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Brief Summary
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the left lobe of the liver in obese patient usually fatty and enlarged and may cause difficulty during bariatric surgery. the aim of this study is to test the impact of routine preoperative ultrasound to evaluate the size of left lobe of the liver as a preoperative predictor for difficulty

Detailed Description
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the left lobe of the liver in obese patient usually fatty and enlarged and may cause difficulty during bariatric surgery. the aim of this study is to test the impact of routine preoperative ultrasound to evaluate the size of left lobe of the liver as a preoperative predictor for difficulty. two equal groups of patients are operated by laparoscopic sleeve gastrectomy with loop bipartition, in one group routine abdominal ultrasound is done, in the other group ultrasound not routinely done.

Official Title
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Preoperative Ultrasonographic Liver Size as a Predictor for Difficulty in Bariatric Surgery

Conditions
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Obesity, Morbid

Intervention / Treatment
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* Other: Routine measurement of left lobe
* Other: control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Morbidly obese patient with BMI more than 40 with or without co-morbidity Morbidly obese patient with BMI more than 35 with co-morbidity Exclusion Criteria: Unfit patients for laparoscopy patients refuse to share in the study revisional surgery for obesity previous upper abdominal surgery

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: preoperative left lobe measurement<br>routine preoperative left lobe measurement | Other: Routine measurement of left lobe<br>* Routine preoperative measurement of left lobe<br>|
| Active Comparator: Control group<br>Control group without routine measurement of left lobe | Other: control group<br>* no routine preoperative measurement of left lobe<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intraoperative maximum diameter of left lobe of the liver | intraoperative maximum diameter of left lobe of the liver in centimeter using intraoperative tape | 4 hours | 
| score of difficulty | score of difficulty from:exposure of the hiatus, retraction of the liver and operative time | 6 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operative time | operative time from skin to skin | 6 hours | 
| incidence of intraoperative complications | incidence of intraoperative complications like bleeding,or injury to intra-abdominal organ | 3 days | 
| early postoperative complications | early postoperative complications like leak or vomiting | 2 weeks |