Obesity and General Surgery

Dr. LEUNG Kai Wing David - Council Member, HKOS

Data from World Health Organization (WHO) showed 13% of adults over the world were obese and 39% were overweight in 2014. It is not surprising that they presented with various surgical conditions to general surgeons, in both elective and emergency settings requiring operations. Compared to people with normal weight, they are high-risk patients who could be nightmares to general surgeons.

They usually suffer from multiple co-morbidities in various systems like diabetes, hypertension and ischemic heart disease, which may need to be stabilized before operations. Operations are more difficult to be performed due to thick abdominal wall which cause difficulty in tracer insertion and also limit the movement of laparoscopic instruments. Presence of large amount of visceral fat also limits the working space for both laparoscopic and open procedures. Studies also showed increased post-operative adverse outcomes like myocardial infarction, wound infection and even death.

With the increasing use of bariatric procedures to treat morbid obesity, the experience and tactics are useful to improve the outcomes for them undergoing any types of general surgery.