New Delhi, Oct. 16 -- Doctors at AIIMS, New Delhi, have successfully performed a laparoscopic hysterectomy on a 44-year-old woman who is 98 cm tall and weighs 22 kg, despite the challenges posed by her severe short stature, osteoporosis and hypertension. The woman has suffered from weak bones and fractures since 2019 due to osteoporosis. For nearly a year, she had also experienced severely painful menstrual periods that disrupted her daily life and frequently required painkillers.
Medical investigations revealed deep pelvic endometriosis and adenomyosis, conditions in which tissue similar to the uterine lining grows outside the uterus or within its muscular wall. Hormonal treatment was considered unsuitable given her age, fragile bones and high blood pressure. Doctors therefore opted to remove her uterus to relieve her symptoms.
"Minimally invasive surgery is now routine for most hysterectomies, but operating on an adult woman of this size, with severe bone weakness and hypertension, poses unusual challenges," said Prof K Aparna Sharma.
Doctors had to take particular care while positioning the patient, as the standard lithotomy position could have caused fractures to her lower back and thigh bones. The enlarged uterus was also adhered to the surrounding intestines, while limited abdominal space added to the complexity.
"We were able to complete the hysterectomy successfully through the laparoscopic route in around 90 minutes," said Prof Reeta Mahey, who performed the surgery.
The anaesthesia team calculated drug doses and permissible blood loss according to the patient's weight, arranged blood in advance and used an ultrasound-guided abdominal block instead of an epidural.
The patient recovered well and was discharged on the third day. Prof Neena Malhotra said the case demonstrated that careful planning could enable patients with severe short stature and fragile bones to benefit from minimally invasive surgery.
Published by HT Digital Content Services with permission from Millennium Post.