Bengaluru, Sept 02: A team of experts led by Dr. Madhuri Vidyashankar and Dr. Vijayalakshmi at Motherhood Hospitals has successfully performed a complex laparoscopic surgery to remove a massive 4.65-kg uterine fibroid from a 28-year-old unmarried woman from South Canara, Karnataka. The tumour, which weighed more than a full-term newborn, was removed using 5 mm laparoscopic incisions and a specialised mini-laparotomy morcellation technique. As the fibroid was too large to be extracted through the laparoscopic ports, the team carefully cut it into smaller pieces and removed it through a small 4-cm incision. Despite the extreme size and high-risk location of the mass, the team successfully reconstructed and preserved the patient's uterus, safeguarding her future reproductive potential.
The patient had lived with the mass largely undetected for years, having experienced regular, pain-free menstrual cycles with no heavy bleeding since the age of 15. It was only when she developed abdominal pain around four months before surgery that scans revealed the large tumour. Pre-operative evaluations revealed that the mass had developed into a rare parasitic fibroid, with an additional blood supply from the omentum, the fatty tissue that covers the abdominal organs. Located on the lateral wall of the uterus and close to major pelvic blood vessels and the ureter, the tumour posed an unusually high risk of significant surgical bleeding.
Fibroids in this location are recognised as being among the more surgically challenging to remove. Published data on lateral and broad-ligament fibroids report complication rates of nearly 19% - more than twice those associated with fibroids in other locations. This is largely due to their close proximity to the ureter and major uterine blood vessels.
To ensure patient safety, Dr. Madhuri’s team spent six weeks stabilising the patient's elevated thyroid levels and optimising her haemoglobin before carefully identifying and ligating the blood vessels supplying the fibroid. The team then separated the mass from the uterus, reconstructed the uterine wall and preserved the uterus. Given the patient's young age, preserving her future reproductive potential was central to the surgical plan. 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, “This was a technically demanding surgery because we were dealing with an exceptionally large fibroid in a very restricted space, located close to major pelvic blood vessels and the ureter. The fibroid had also developed an additional blood supply from the omentum, making control of the feeding vessels critical before we could safely remove it. Once the blood supply was controlled, our priority was to separate the fibroid carefully, reconstruct the uterine wall and preserve the uterus. Because the mass was too large to come out through the laparoscopic ports, we used mini-laparotomy morcellation, carefully reducing the fibroid into smaller pieces and removing it through a small 4-cm incision. The successful outcome allowed us to achieve both safe removal of a very large and complex fibroid and preservation of the patient’s future reproductive potential.”
Speaking after the surgery, the patient said, “I had been having abdominal pain for a few months, but I never imagined that I had a tumour of this size. When the scan revealed the fibroid, my family and I were very worried about the surgery. I am relieved that it is now over and that my uterus could be preserved. I already feel a significant difference and feel much lighter after the surgery. I am grateful to the doctors for taking care of me and helping me through this.”
Beyond the clinical success of this procedure, the case points to a serious trend of complex gynaecological problems becoming more common among young women within their twenties, which was not common before among this demographic bracket. The shift is borne out in global data too: in the most recent ‘Global Burden of Disease’ study, India's fibroid incidence has been seen rising faster than in almost any other region studied worldwide, with new diagnoses increasingly appearing from adolescence onward rather than only in mid-life. This emphasizes the urgent necessity of regular preventive check-ups for young women. Routine pelvic ultrasounds during annual health exams are essential for catching hidden growths early, allowing for timely medical management before a condition threatens organ safety, overall health, or future fertility.