| October 2007 · Vol. 19, No. 10 SURGICAL TECHNIQUES
Risks and remedies when your surgical patient is obese
How to plan and safely manage surgery—and ensure that the patient’s expectations are realistic
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Fast Track
The risk of thromboembolism remains heightened as long as 3 weeks after hospital discharge
Ask an obese surgical patient about less obvious disorders such as sleep apnea, which can have grave postoperative implications
Consider regional anesthesia when it is feasible; it can limit complications related to diminished pulmonary function
Use extra-long instruments in an extremely large patient, especially if she has a “deep” pelvis
Begin ambulation on the first postoperative day—or on the evening after surgery, if circumstances permit
If the patient has a significant comorbidity, she should remain under the care of her internist or other primary care provider
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James
D.
Perkins,
MDDr. Perkins is Clinical Assistant Professor of Obstetrics and Gynecology at the University of Mississippi Medical Center in Jackson. Richard
A.
Jackson,
MDDr. Jackson is Staff Anesthesiologist at the Delta Regional Medical Center in Greenville, Miss.
The authors report no financial relationships relevant to this article.
The adverse consequences of obesity go far beyond aesthetic and psychosocial concerns. Patients who are markedly overweight face a real risk of developing severe health conditions—not just cardiac disease, diabetes mellitus, and hypertension, but also sleep apnea, venous thromboembolism, certain cancers (particularly breast and uterine), and biliary tract disease. Obesity also contributes to menstrual abnormalities and infertility and may complicate pregnancy.
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