Managing obesity in gynaecological surgery

The incidence of obesity is rising worldwide. This is contributing to an increase in complexity around perioperative care in all surgical specialties including gynaecology. A holistic approach is essential when managing obese women requiring surgery. A multidisciplinary team is strongly advised in the process of selecting women for surgery. Careful emphasis must be placed on pre-operative and postoperative care with focus on prevention of additional complications associated with obesity. Weight management clinics may have an important role in the pre-operative planning stage. It may be safer to defer surgery in selected cases whilst conditions are optimised or cancel surgical options altogether when surgery is deemed too high risk. This may include women with gynaecological cancers who would otherwise be advised surgery. We aim to outline the challenges encountered in the management of obesity in gynaecology and discuss various methods to optimise care when surgery is necessary.