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E u r o p e a n C o n g r e s s o n
Obesity and
Eating Disorder
Journal of Obesity & Eating Disorders
ISSN 2471-8203
A p r i l 1 2 - 1 3 , 2 0 1 8
Am s t e r d a m , N e t h e r l a n d s
Obesity 2018
Page 32
O
besity is rising all over the world and is associated with increased risk of
adversepregnancyoutcomes. Cesareansection is themost frequent operation
worldwide. Once in a while, caesarean section has to be done on obese parturient
and needless to say that obesity is associated with other maternal as well as fetal
metabolic risks. There is a direct correlation between surgical steps and their
influence on post-surgical pain. Therefore, every single step in each operation
should be based on studies comparing different methods taking into account
the outcome. Different surgeons perform operations with the same indication
in different ways. The lack of standardization does not enable comparison and
certainly not meta-analysis. This was the reason why we started to evaluate the
outcome of single steps and their combinations on the post-operative pain as
well as on the mobility and well-being of the parturient. Among our parturients
were 19 women with BMI 38–41. The modified Joel-Cohen method proved not
just to reduce febrile morbidity, but to have direct influence on post-operative
pain. A direct correlation was found between the outcome of surgeries which
used to suture the uterus with one or two layers, suturing peritoneum or leaving it
open as well as the suture material and the size of the needles. Amazingly, it was
shown that the higher the BMI, the less blood loss from the abdominal wall when
using this technique and less stitches are needed to close the skin. There was no
difference concerning febrile morbidity, mobility after the surgery or the use of
analgesics compared to women with normal BMI. Without exception, scores of
studies showed that following these steps the post-operative pain and the need
for analgesics are significantly reduced.
Biography
Michael Stark is specialized in Obstetrics and Gynecology. His
main interest is Gynecological Oncology. He is currently the Sci-
entific and Medical Advisor of ELSAN, a 120 hospital group in
France and is a Guest Scientist at the Charité University Hospi-
tal in Berlin. He is the President of the New European Surgical
Academy (NESA), an international inter-disciplinary surgical or-
ganization. In 2011, he was nominated as the Medico Del Anno
(Doctor of the Year) in Italy, and is an Honorary Member of the
French, Polish, Russian and Italian Gynecological Associations.
During the years 1983-2000, he was the Medical Director and
Head Of Ob/Gyn Department of the Misgav Ladach General
Hospital in Jerusalem, and between 2001 and 2009 the Chair-
man of all Ob/Gyn Departments of the HELIOS Hospital Group.
He was Visiting Professor in universities of Toronto, Moscow,
Beijing, Milan, Adana, Uppsala and the Weill-Cornell University
Hospital in New York.
mstark@nesacademy.orgCaesarean section in extremely obese
parturients
Michael Stark
1, 2, 3
1
New European Surgical Academy, Germany
2
Charité University Hopsital, Germany
3
ELSAN Hospital Group, France
Michael Stark, J Obes Eat Disord 2018, Volume: 4
DOI: 10.21767/2471-8203-C1-007