IS SURGERY ON OBESE PATIENTS MORE DIFFICULT?

Being overweight is notoriously bad for your health. But does obesity pose some additional risks when undergoing surgery?

A team of surgeons during a medical operation. Image credit: NCI

Why is obesity considered a complication during surgery?

Obesity is considered a significant complication during surgery due to several reasons that impact both the process of surgery and the recovery period. To put it simply, it is much better NOT to be overweight when undergoing any medical intervention.

Here are some of the main concerns as explained below:

1. Surgical access and duration of the procedure

The team of surgeons has more work when taking care of an obese person. Cutting through the layer of fat isn’t necessarily difficult. However, holding the excess skin and fat may require an additional person in the operating room.

Excess body fat, particularly in the abdominal area, can obscure anatomical landmarks and make it difficult to access the operative site, thus increasing the complexity of surgical procedures. This may require additional incisions or more complex approaches, which inherently increase the risk of complications such as bleeding or damage to surrounding tissues.

The extended duration of surgery not only exposes the patient to anesthesia for longer periods but also increases the likelihood of intraoperative complications such as blood loss and hypothermia. Furthermore, longer surgeries mean more time in a static position, which can exacerbate issues related to pressure sores and nerve compression.

2. Increased risk of infections and related complications

In obese patients, the excess skin folds of an obese patient are warm and moist. Therefore, they make it easier for an infection to spread. The deeper and more numerous skin folds in obese patients can harbor bacteria. The combination of impaired immunity and challenging wound care management often results in a higher rate of post-surgical site infections, which can lead to prolonged hospital stays and additional interventions, including rehospitalization and further surgery.

Overweight patients are also more likely to have comorbidities, such as diabetes or heart disease, that may increase the chance of complications during the operative medical procedure and make anesthesia riskier.

Obesity also increases the likelihood of developing venous thromboembolism due to factors like decreased mobility, venous stasis, and hypercoagulability. The compression of leg veins by excess body weight can slow blood flow, increasing the risk of clot formation.