Sarcouncil Journal of Medicine and Surgery

Abstract: Obesity is an expanding health issue across the world, where prevalence rates are more than 40 percent. Higher body mass index (BMI) in the surgical field has been a persistent and consistent source of harder and long operating times and complications in several specialties. The objective of the study was to determine the role of obesity on the outcome of the decision regarding surgical techniques, intraoperative outcomes, and postoperative results of the patients undergoing gynecological operations. A case study was examined on 117 patients that experienced gynecological surgery as a cross-sectional study in different hospitals in Iraq in March 2024 - March 2025. The stratification of patients based on the World Health Organization classification was into five categories according to the BMI: normal weight (18.5-24.9 kg/m2, n = 26), overweight (25.0-29.9, n = 34), obese Class I (30.0-34.9, n = 30), obese Class II (35.0-39.9, n = 17), and obese Class III (40.0, n = 10). In this study, there was a registration of surgical outcomes of patients achieved in various attributes, such as the use of surgical approach, durations of operations, estimated blood loss, intraoperative and postoperative complications, conversion rates, hospital length of stay, and 30-day readmission or reoperation rates. The open surgery method also grew more important with BMI, as among normal body weight patients, it was 19.2 per cent, and among patients with class III obesity, it was 80.0 per cent. The increase in the operative time was gradually ascending between 87.4 (SD 28.6) minutes in the normal-weight group and 152.6 (SD 51.8) minutes in the Class III obesity group. The estimated blood loss rose across the BMI categories; 148.5 (SD 89.2) mL and 412.3 (SD 268.9) mL, respectively. Intraoperative complications were seen in 7.7 percent of normal versus 50 percent of Class III obese, and post-operative complications increased to 11.5 percent to 70 percent. Minimally invasive surgery was 4.8, which is converted to open surgery, and rose to 50.0. The length of stay in the hospital grew to 5.8 (SD 3.2) days as compared to 2.1 (SD 1.0), and the 30-day readmission rates increased to 20.0 as compared to 3.8%. An increase in the BMI is greatly linked with changing to an open operation, increased surgical time, increased blood loss, increased complication rates during and after the surgery, increased cases of conversion to open operation, hospitalization, and higher rates of 30-day readmission during gynecological operations.