Surgery on obese a weighty problem

Morbidly obese patients are causing weighty problems in the operating theatre, anaesthetists say.

Obesity has become such a significant health concern in New Zealand and Australia that an entire session of the College of Anaesthetists conference, which ends in Christchurch tomorrow, was devoted to the challenges of performing surgery on portly patients.

Wellington Hospital anaesthetist Graham Sharpe, who spoke at the conference, told The Dominion Post that obesity made every stage of surgery more complicated. “Everything’s just sort of magnified.”

Not only were obese people more likely to suffer complications during or after surgery, their size made something as simple as taking blood pressure much more difficult.

“Those cuffs on their arms, when they’ve got a very fat arm, are very unreliable.”

Inserting IV drips was also harder. “For someone who’s got a lot of fat tissue, their veins are often buried and hard to find.”

Morbidly obese patients were also more likely to develop leg clots and pressure sores during surgery.

It could sometimes be difficult to give large patients the right doses of painkillers or anaesthesia, Dr Sharpe said.

“You calculate drugs on somebody’s lean body size. You can end up overdosing [obese patients].”

One in five New Zealanders are obese and 6 per cent are classified as morbidly obese.

Dr Sharpe said he had only anecdotal evidence that more obese people were having surgery, but believed the rise was indisputable.

“Everybody’s saying we’re getting more and more obese patients.”

The number of people having bariatric surgery in public hospitals has increased from 10 in the 2000-01 financial year to 247 during 2008-09.

Another 400 people a year pay for private surgery.

In recent years, hospitals have invested thousands of dollars in equipment that can cope with increasingly heavy patients.

Wellington Hospital’s normal theatre beds can bear up to 350 kilograms and the hospital also has specialist laproscopic surgery equipment for doing keyhole operations on obese patients, hoists to move them around, large wheelchairs and heavy-duty commodes.

Ambulance services are also looking at buying specialist equipment to take big patients to hospital.

In 2008, a 300-kilogram man needed the help of six firefighters to get out of an ambulance, and last July, a Rotorua man thought to weigh 400kg was cut out of his home and removed with a forklift for treatment after a fall.

The direct cost of obesity to the health sector is about $460 million a year.

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