In a notable medical achievement, a 134-kg postmenopausal woman with abnormal uterine bleeding was successfully treated through a complex minimally invasive procedure at Terna Speciality Hospital & Research Centre, Nerul. Postmenopausal bleeding is a critical symptom that requires prompt evaluation, as it may indicate underlying pathology.
Timely Diagnosis and Clinical Findings
Upon evaluation, the medical team performed a hysteroscopic-guided biopsy, which revealed atypical endometrial hyperplasia—a precancerous condition that can progress to malignancy if left untreated. Consequently, the team planned a laparoscopic hysterectomy as the definitive treatment.
Pre-Operative Optimisation and Risk Management
However, the case presented significant challenges. The patient had a very high body mass index (BMI) and severe obstructive sleep apnea (OSA), making her a high-risk candidate for general anaesthesia. Airway management and ventilation in such cases demand advanced expertise. Therefore, Dr. Nikhil Varge, the treating physician, carefully optimised the patient’s condition pre-operatively, ensuring all clinical parameters were stabilised. He also played a crucial role in post-operative care, closely monitoring the patient in the ICU to ensure a smooth recovery.
Surgical Expertise in Complex Conditions
As per the press release, the surgical team, led by Dr. Amrita Kesari, Laparoscopic Surgeon (Obs & Gyn), meticulously planned and executed the procedure. Due to excessive visceral fat, accessing the abdominal cavity was technically demanding. Nevertheless, the team used specialized bariatric ports to safely perform the surgery. Despite the complexity, they completed the procedure successfully without complications.
“Managing such high-risk patients requires meticulous planning and a multidisciplinary approach. Minimally invasive techniques, when executed with the right expertise and infrastructure, can significantly reduce recovery time and surgical risk even in complex cases,” said Dr. Amrita Kesari.
Critical Role of Anaesthesia and Perioperative Care
Equally important was the contribution of the anaesthesia team, led by Dr. Sujata Pawar. The team ensured smooth intubation and extubation while effectively managing risks associated with obesity and OSA. Additionally, advanced monitoring and comprehensive perioperative care helped maintain patient stability throughout the surgery.
Successful Outcome and Key Takeaways
Following the procedure, the patient expressed relief and gratitude, appreciating the coordinated care and reassurance provided by the team.
This case highlights the importance of early diagnosis, thorough planning, and multidisciplinary collaboration in managing high-risk patients. Moreover, it reinforces the need for timely medical attention for postmenopausal bleeding, which can often serve as an early warning sign of serious underlying conditions.