Doctors have successfully operated and removed a watermelon-sized non-cancerous tumour weighing 2.2 kgs from the uterus of a 49-year-old woman via robot-aided surgery. The surgery lasted for 3 hours and was performed by a team of doctors at Fortis Hospital, Noida. The team was led by Dr Anjana Singh, Director & HOD of Obstetrics and Gynaecology at Fortis Hospital, Noida. The patient was discharged in stable condition two days later.

When the patient was admitted to the hospital, she complained of severe pain during her menstruation cycle, along with irregular and heavy bleeding for almost 2 years. An ultrasound revealed a large fibroid (tumour) measuring 17-18 cm in size along with other fibroids of 7-8 cm. These fibroids usually form when the body secretes excessive oestrogen, which causes the growth of fibroid tissues.

The large mass of tumour had occupied the entire abdominal area, thus making it extremely difficult to operate. Also, the patient had undergone two prior C-sections, and her scars were vertical. In such cases, there is always a risk of injury to the vital organs during the dissection of the adhesions.

Therefore, a Robot-assisted surgery was used to better identify the anatomical structures and minimize the risk of unintended damage to the internal organs.

Speaking on the details of the case, Dr Singh said, “The patient had travelled from Aligarh, as there she was advised to undergo traditional open surgery by multiple gynaecologists, which the patient did not want to opt for. That’s when she came to Fortis. In this case, the tumour had grown to the size of a watermelon. We had to be extremely careful while operating to save the vital organs, and that’s where robot-assisted surgery provided enhanced precision.”

The surgery involved very little intraoperative bleeding with no requirement for blood transfusion, owing to high precision. The most challenging part of this surgery was to retrieve such a heavy tumour from 8 mms miniature incisions on the abdomen used for the robotic arms and camera. The team decided to break down the tumour in a bag inside the abdomen followed by removal of small pieces of fibroid from the very small incision.

Dr Singh said that had the surgery not been performed on time, the fibroid would have grown immensely in size and would have put pressure on surrounding organs such as bowel and bladder, thereby, causing intestinal obstruction and urine retention. Bleeding and pain during menstruation cycle would also have increased and excessive bleeding could have made the patient severely anaemic. “Such cases are rare as tumours weighing 2.2 kgs are found in only 10-20% cases and in 1% of such cases, a massively growing fibroid can become malignant.”

Mohit Singh, Zonal Director, Fortis Hospital Noida said, “This was a very critical and challenging case considering the size and weight of the tumour, along with two c-section surgeries in the past. Despite the challenges, the surgery was successfully conducted owing to the correct medical assessment and the patient was able to resume her daily routine in just one week of surgery.”