Chairs: Hubert Fornalik

Faculty: Maram Said, Hubert Fornalik, Dario R. Roque

Description: The course provides a review of our approach to surgeries in morbidly obese patients with BMI up to 83. We discuss preoperative, intraoperative and postoperative management along with 52 modifications to standard techniques that we have adopted with special focus on management of steep Trendelenburg position (40 degrees) and anesthesia. Exposure, surgical technique, instruments and positioning will be discussed. Presentation is enhanced by intraoperative videos and tutorials.

With ever increasing rates of morbid obesity and poor access to care, there are more and more patients needing complex gynecologic surgery. In this course, we present unpublished observations about surgeries in morbidly obese patients, including poorly understood issues related to positioning and ventilation. This practical guide on managing surgeries in morbidly obese patients can be implemented in almost any setting. 

Learning Objectives: At the end of this course, the participant will be able to:

1. Objective Understand unique aspects of physiology and anatomy of morbidly obese patients as they apply to ventilation and positioning
2. Objective Identify preoperative surgical anesthesia and postoperative modifications that can improve outcomes
3. Objective Know how to transform surgery in morbidly obese patients to (almost...) standard surgery.

Course Outline

11:00 AM Welcome, Introduction and Course Overview

H. Fornalik

11:05 AM Clinical Evidence for Successful Robotic Surgeries in Patients with BMI>40

M. Said

11:20 AM Anesthesia Management During Surgery

H. Fornalik

11:35 AM Positioning Morbidly Obese Patients: 40-Degree Trendelenburg Position, Instruments, Equipment and Techniques

D. Roque

11:50 AM Discussion Questions & Answers

11:00 AM Adjourn