Total Laparoscopic Hysterectomy (TLH) in Obese Patients by the Comprehensive Canopy Technique, ‘3 Step Technique’

Obesity, a global epidemic with 500 million affected, sees approximately a 20% annual rise. It is defined by a BMI ≥30, posing challenges in surgical scenarios. Minimally invasive approaches are favored, but accessing the abdomen is complex due to fat and scars. Proper evaluation of a patient’s body type is essential, including attention to weight distribution and waist-hip ratio. Thorough preoperative evaluation by a multidisciplinary team is crucial to formulate and execute the surgical plan. Total Laparoscopic Hysterectomy (TLH) in obese patients involves distinct steps to address challenges associated with visceral, perivascular and peritoneal fat. Comprehensive Canopy Concept, ‘The 3 Step Technique’, diluted vasopressin, and articulating instruments are highlighted as key components to ensure optimal outcomes. The postoperative considerations emphasize adherence to Enhanced Recovery After Surgery (ERAS) protocols, pain management, and vigilant care for morbidly obese patients. Additionally, the chapter explains long-term impact on obesity-related comorbidities and the importance of counselling patients for lifestyle modifications.