Obesity is an increasing problem. It is essential that staff involved in treating obese patients are fully trained and that there are departmental protocols and guidelines in place to advise on the management of these patients

Team@CMHF

• As the overall incidence of obesity is on the rise, the risk of surgical complications also increases.
• A BMI of more than 30 indicates obesity, however, the principal concern in surgical practice is for people with a BMI of more than 40 (morbid obesity), as this has additional risks in itself.
• Many gynaecological conditions can be treated without surgery and weight loss alone will improve conditions such as stress incontinence.
• Conservative therapies, such as bladder retraining and physiotherapy for urinary problems; and pessaries for prolapse, should readily be considered for women who are obese
• If surgery is required, obese women should receive counseling about the increased risk of complications and technical difficulties that may be encountered.
• In preparation for surgery, preoperative evaluation including a cardiovascular and respiratory history and relevant examination is needed. In each case, weight and height should be recorded and the BMI calculated and clearly documented in the notes.
• The possible risks from surgery include

1. Infection
2. Bleeding
3. Organ damage
4. Thromboembolism

• In addition there can be anaesthetic problems which include

1. Airway and ventilation problems
2. Nausea and issues with lifting and moving the patient.

• Every operating table, trolley and bed should be labeled with its maximum weight capacity and that special hospital beds should be available that can accommodate the weight and enable movement of the patient.
• During open surgery, obesity presents problems as there is an increased risk of wound infection and wound failure.

More at http://www.rcog.org.uk/news/tog-release-clinicians-need-be-aware-surgical-risks-obesity-gynaecology