Tricks of performing cesarean section in extremely obese women (morbidly women and cesarean delivery)

1. Do not make a cut in the skin where the skin groove between the abdomen  and the loin is. 
2. make a cut at the maximum  bulge of the abdominal skin
3. Use a Alexis retractor (http://www.youtube.com/watch?v=CnS2mYLpTts) so that you do not need two assistants. Otherwise you will need two assistants
4. Always leave a peritoneal and subrectus sheath drain. As it will be extremely difficult to identify if the woman suffers postoperative bleeding.
5. Use mass closure technique if midline incision
6. Close the subcutaneous tissue if its depth exceeds a depth of 3cms.
7. Use metal clips for the skin as this will let the fluid and other exudates from the wound to seep out.