Laparoscopy in obese women

Many bariatric surgeons have gained a lot of experience to operate in obese patients because of the increased demand in gastric banding surgery to control obesity. However, their experiences are not without controversies regarding the surgical risks in the obese patients. There were some studies showing obese patients undergoing laparoscopic surgery had a higher conversion rate, longer operative time, higher complication rate and longer hospital stay.

While gynaecologists do not have great experience to operate in obese patients, especially those from Asian countries where many of their patients are non-obese, but obesity is now an increasing problem in these countries. Some women with infertility and polycystic ovarian syndrome are obese. Some patients with endometrial cancer are also obese women. They have presented with difficulty in pelvic examination and imaging and also lead to technical difficulties in laparoscopic surgery. In this presentation, the author would like to share his experience of performing laparoscopic surgery in obese ladies in Australia where he encountered many obese Australian women and Pacific Islanders who are both overweight and obese. From his experience it is true that these obese patients have longer operative time, higher conversion rate and longer hospital stay. Yet, experienced surgeons usually can overcome the issues of conversion rate and complications. Even though the operative time and the length of stay may be longer, the laparoscopic surgery in these obese women is comparable to the other surgical approaches like abdominal and vaginal surgery.

In this presentation, the author will discuss the techniques of laparoscopic surgery in this group of obese women. These techniques would help to perform laparoscopic surgery successfully without conversion and to avoid complications. Hopefully obese patient can also benefit from those minimally invasive procedures with less pain, less wound infection, less complications and early return to work.