A friend who is a surgeon does a lot of laparoscopic procedures, including for various forms of cancer. He tells me that it is harder to use so-called keyholes on grossly overweight patients, but nonetheless it is done if it can be, because there are so many benefits to avoiding an open incision whenever that is reasonably do-able (which it may not be if a mass is very large or if it is hard to tell where a mass extends to without 'going in for a real look around').
Almost off topic, but since this is officially a medicine and law thread now I will mention that my y spouse, who is an anaesthesiologist, gets a premium payment from OHIP for any case where the patient's BMI is 40 or more. She tells me it takes more effort to control the flow, wear-off time, etc. of the injected and inhaled drugs used in anaesthesia if a patient is grossly overweight.
