Video Objective This objective of this video is to review surgical considerations for the obese patient undergoing minimally invasive surgery. Setting The obese patient is the patient considered. This video addresses risks of laparoscopic surgery, differences in patient counseling, prophylactic measures, patient positioning, laparoscopic entry, management of the panniculus, and prevention of conversion to an open procedure. Interventions Interventions for prophylactic measures include placement of an orogastric/nasogastric tube prior to intubation, increased dose of antibiotic prophylaxis, and optimization of hemoglobin A1c for diabetic patients. Interventions for optimizing patient positioning include allotting extra time for procedures, utilizing bariatric beds and stirrups, anti-skid material and padding during surgery, tucking the patient's arms, and applying a chest strap. Interventions for laparoscopic entry include utilization of bariatric trocars, placing trocars more laterally and cephalad, left upper quadrant or supraumbilical entry, and inserting ports at a 90 degree angle to the abdomen. Interventions for panniculus management and prevention of conversion to an open procedure include limiting the use of steep Trendelenberg, decreasing the insufflation pressure, mechanically retracting the panniculus, and performing a tilt test. Conclusion Gynecologic surgeons will inevitably be operating on more obese patients with coming years given the rising prevalence of obesity. Thus, they should be prepared for preoperative evaluation of the obese patient, surgical preparation, patient counseling, and surgical optimization to prevent conversion to an open procedure, all of which are addressed in this video. Preventing conversion is a balancing act between improving surgical visualization and maintaining stable cardiac and respiratory status of the patient. With increasing volume of cases, gynecologic surgeons can become proficient at minimally invasive surgery for the obese patient, thus, decreasing their operative morbidity and post-surgical quality of life.