Mumbai – In a notable medical achievement, a 134-kg postmenopausal woman presenting with abnormal uterine bleeding was successfully treated through a complex minimally invasive procedure at Terna Speciality Hospital & Research Centre, Nerul, despite significant surgical and anaesthetic risks. The patient reported bleeding after menopause, a symptom that often requires immediate evaluation. At Terna Speciality Hospital & Research Centre, a hysteroscopic-guided biopsy was performed, which revealed atypical endometrial hyperplasia, a precancerous condition of the uterus that can progress to cancer if left untreated. Given the diagnosis, a laparoscopic hysterectomy was planned. However, the case posed serious challenges. The patient had a very high body mass index (BMI) along with severe obstructive sleep apnea (OSA), making her a high-risk candidate for general anaesthesia. Managing airway and breathing in such cases requires advanced expertise and precision. Importantly, the patient’s condition was optimised pre-operatively under the care of Dr. Nikhil Varge, the treating physician, who ensured that all medical parameters were stabilised before surgery. His role extended into the post-operative phase as well, where he closely managed the patient’s recovery in the ICU, ensuring a safe and smooth transition.
The surgical team was led by Dr. Amrita Kesari, Laparoscopic Surgeon (Obs & Gyn) from Terna Speciality Hospital & Research Centre, who carefully planned and executed the procedure. Due to excess visceral fat around internal organs, the surgery was technically demanding. Specialized bariatric ports were used to safely access and operate within the abdominal cavity. Despite the complexity, the procedure was completed 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. Equally critical was the role of the anesthesia team, led by Dr. Sujata Pawar. The team ensured smooth intubation and extubation, addressing the risks associated with OSA and obesity. Advanced monitoring and perioperative care played a key role in maintaining patient stability throughout the surgery. The patient expressed relief and gratitude following the successful outcome, highlighting the coordinated care, safety, and reassurance provided by the team.
This case underlines how early diagnosis, careful planning, and coordinated expertise can help manage even high-risk patients safely. It also reinforces the importance of seeking timely medical attention for postmenopausal bleeding, which can often be an early warning sign of serious conditions.