In 2004, an estimated 140,000 people underwent gastric bypass surgery. The morbidly obese patient presents with additional complications for surgery including gastric bypass surgery. Insertion of an anesthesia tube into an airway may be difficult. Fat absorbs drugs and anesthetic gases, requiring a much higher dose. Large amounts of fat separating the abdominal organs often slip obscuring vital organs. Suturing may be difficult with fat covering organs. Pulmonary embolism and post-operative pneumonia occur more often in an obese patient. The size and depth of wound can present for a more complex recovery. A skilled and knowledgeable surgery team is imperative.