A supraumbilical incision for gynecologic neoplasms in the morbidly obese patient.

Abstract

Surgical treatment of the pelvic area in obese patients can be extremely difficult. It is accompanied by a higher rate of complications, during and after the operation. A new approach aimed to facilitate exposure and to decrease the rate of postoperative complications is presented. Various surgical procedures were performed upon 23 patients with benign and malignant gynecologic disease. The panniculus were pulled down to localize the umbilicus over the symphysis pubis. The pelvis and upper part of the abdomen were explored through a supraumbilical incision. There were no vascular, neurologic or urinary injuries. The mean operating time was relatively short, and there was no excessive blood loss. No patient had postoperative ileus. Incisional hernia did not develop in any of the patients during three years of follow-up study. This incision provides excellent exposure. It heals well and has a very low complication rate.