A woman suffering from progressive abdominal distension, heavy menstrual bleeding, and severe pressure symptoms was finally relieved of years of distress a few days ago at Mandav hospital in Mandi.
The patient had been living with a massive uterine fibroid — equivalent in size to a full-term pregnancy — for several years, significantly affecting her quality of life.
Given the exceptional size of the uterus, surgical removal was imperative. After clinical evaluation, pre-operative planning, and risk assessment, a minimally invasive laparoscopic approach was chosen despite the challenges traditionally associated with such large fibroid uteri.
The surgery was successfully performed at Mandav Hospital in Gutkar by Dr Uday Bhanu Rana, Consultant Gynaecologist and Advanced Laparoscopic Surgeon.
The procedure lasted approximately 3 hours and was technically demanding. The challenges included the extraordinary size and weight of the uterus, severely distorted pelvic anatomy, markedly restricted operative space, and significantly increased vascularity — factors that substantially elevate surgical risk.
Advanced 3D laparoscopic vision, careful and methodical dissection, and step-wise devascularisation techniques were employed to maintain surgical safety. The surgery was completed without any intra-operative or post-operative complications.
Laparoscopic removal of a fibroid uterus of this magnitude is exceedingly rare. Based on a review of available medical literature and previously reported cases, the largest fibroid uterus removed laparoscopically in India prior to this weighed approximately 4.5 kg.
In this case, the uterus weighed 5.21 kg, placing it among the largest fibroid uteri ever managed through a purely laparoscopic approach.
Dr Rana was assisted by a team comprising Dr Priyanka Sharma, Dr Anshit Pathania, nurses Shivani Sharma and Harshita Sharma, and OT assistants Mahesh and Jatin.
