A team of specialists at Motherhood Hospitals, Indiranagar, Bengaluru, has successfully removed a massive 4.65-kg uterine fibroid from a 28-year-old woman through complex laparoscopic surgery while preserving her uterus and future reproductive potential. Led by Dr Madhuri Vidyashankar and Dr Vijayalakshmi, the surgical team used 5-mm laparoscopic incisions along with a specialised mini-laparotomy morcellation technique to remove the unusually large tumour. The fibroid was too large to extract through the laparoscopic ports. Therefore, the surgeons carefully divided it into smaller pieces and removed it through a small 4-cm incision. Despite the tumour’s size and challenging location, the team successfully reconstructed the uterine wall and preserved the uterus.
Fibroid Remained Undetected for Years
The 28-year-old woman from South Canara, Karnataka, had lived with the fibroid largely without symptoms for several years. Although she had regular and pain-free menstrual cycles since the age of 15, she did not experience heavy bleeding that might have indicated an underlying problem. However, abdominal pain that developed around four months before the surgery prompted medical evaluation. Imaging subsequently revealed the presence of the massive tumour. Further pre-operative assessment identified the mass as a rare parasitic fibroid. Unlike typical fibroids, the tumour had developed an additional blood supply from the omentum, the fatty tissue that covers the abdominal organs.
Tumour Located Near Major Blood Vessels and Ureter
The fibroid had developed on the lateral wall of the uterus, close to major pelvic blood vessels and the ureter. As a result, the location significantly increased the risk of severe bleeding during surgery. Fibroids in the lateral and broad-ligament regions are considered particularly challenging to remove because of their proximity to critical pelvic structures. Published data on these fibroids indicate complication rates of nearly 19%, which is more than twice the rate reported for fibroids in other locations.
Surgeons Prepared Patient Before Complex Surgery
To improve surgical safety, Dr Madhuri’s team spent six weeks medically optimising the patient before the procedure. The doctors first stabilised her elevated thyroid levels and improved her haemoglobin levels. They then carefully identified and ligated the blood vessels supplying the fibroid before proceeding with its removal. Once the blood supply was controlled, the surgeons separated the tumour from the uterus and reconstructed the uterine wall. This approach allowed them to remove the large mass while preserving the uterus. Because of the patient’s young age, preserving her future fertility remained a central objective throughout the surgical planning.
Mini-Laparotomy Technique Enables Safe Removal
The enormous size of the fibroid presented another challenge: the tumour could not pass through the small laparoscopic ports. To overcome this, the surgical team used mini-laparotomy morcellation. They carefully divided the fibroid into smaller pieces and removed them through a 4-cm incision. This minimally invasive approach helped the team manage the unusually large tumour while limiting the size of the surgical incision.
Patient Recovers Well After Surgery
Following the successful procedure, the patient is recovering well and has reported significant relief. Dr Madhuri Vidyashankar P, Consultant – Hysteroscopic & Laparoscopic Surgeon and Gynaecologist, Motherhood Hospitals, Indiranagar, Bengaluru, said the surgery was technically demanding because of the fibroid’s exceptional size, restricted location and proximity to major blood vessels and the ureter. She explained that the tumour’s additional blood supply from the omentum made controlling the feeding vessels particularly important before removal. As per the press release, according to Dr Madhuri, the surgical team prioritised three objectives: safe removal of the fibroid, reconstruction of the uterine wall and preservation of the uterus. She added that mini-laparotomy morcellation allowed the surgeons to reduce the large mass into smaller pieces and remove it through a small incision. Ultimately, the procedure achieved both safe removal of the complex fibroid and preservation of the patient’s future reproductive potential.