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Hysterectomy in Obese Patients: Special Considerations

MATTHEWS, KIRK J. MD; BROCK, ELLEN MD; COHEN, STEPHEN A. MD; CHELMOW, DAVID MD

Clinical Obstetrics and Gynecology: March 2014 - Volume 57 - Issue 1 - p 106–114
doi: 10.1097/GRF.0000000000000005
Hysterectomy 2014: Indications and Techniques

A literature search was performed to find evidence-based practices that aid in the preoperative evaluation, intraoperative techniques, and postoperative management of the obese patient requiring hysterectomy. Complications are more frequent than in normal weight patients and are more difficult to manage. Few studies provide direct evidence with which to help guide surgical decision-making and postoperative management. However, there is sufficient evidence to support that when feasible, the vaginal route is preferable in obese patients. Techniques validated for normal weight patients like antibiotic and thromboembolism prophylaxis seem effective in obese patients, and are likely even more important.

Virginia Commonwealth University Medical Center, Richmond, Virginia

The authors declare that they have nothing to disclose.

Correspondence: David Chelmow, MD, Virginia Commonwealth University School of Medicine, Richmond, VA. E-mail: dchelmow@mcvh-vcu.edu

© 2014 by Lippincott Williams & Wilkins.