Supra-umbilical vertical midline abdominal incision in morbidly obese gynaecological oncology patients

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The prevalence of obesity is rapidly increasing globally. Female malignancies linked to obesity comprise approximately 51% of newly diagnosed cancers. Endometrial, breast, ovarian and cervical cancers have been associated with obesity. Obesity presents problems with laparotomy incision placement and closure. Access to the pelvis can be challenging and there is a higher incidence of intraoperative complications. We review the outcome of seven patients where a supra-umbilical midline vertical laparotomy incision has been used in an attempt to minimise the surgical morbidity.