How could you management in the class III obese patient to do Gynecologic Laparoscopic surgery? = How could you management in the class III obese patient to do Gynecologic Laparoscopic surgery?

다국어 초록 (Multilingual Abstract)

All over the world, obese people was twice since 1980. In 2014, over 1.9 billion adults were overweight, including over 600 million obese people. Obesity is worldwidely critical problem, and the people have high risk of morbid conditions such as hypertension, diabetes mellitus, hypercholesterolemia, obstructive sleep apnea, and malignancies including endometrial cancer and breast cancer. If obese patients is operated, the surgeons have to prepare more carefully in operation. Also, post operation complications including surgical site infection, venous thrombus and wound complications are more prevalent in them than normal-weight patient. The same applies to Gynecologic surgery. We reported the case of laparoscopic surgery in class III obese woman (class I obesity is defined as a BMI of 30 to less than 35; class II obesity is defined as a BMI of 35 to less than 40; and class III obesity is defined as a BMI of 40 or greater, is considered morbid obesity) because Endometrial hyperplasia without atypia was diagnosed by dilatation and curettage of uterus. In the preoperative stage, basically, we performed chest x-ray, an electrocardiogram, echocardiography and laboratory evaluation were also performed. In the intraoperative stage, She was posted the HELP (head elevated laryngoscopy position) using blankets under back, shoulders and the head and neck to provide sufficient lift for airway visualization. She underwent laparoscopic hysterectomy with bilateral salpingo-oophorectomy, the surgery finished well. Although, The patient was discharged without any complication at 4 days after surgery, She re-entered hospital due to operation wound problem. After additional treatment such as dressing, antibiotics medications, the wound healing is finished. The more obese patients, the more doctors face same problems as above. Therefore, Gynecologic surgeons should have the knowledge of care and guidelines for preoperative, intraoperative and postoperative management.