NEW DELHI: Careful planning by a team of multidisciplinary doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, has helped a 44-year-old woman, just 98 cm tall and weighing 22 kg, undergo a complex surgery to relieve nearly a year of severe pelvic pain.
The woman, identified as Meera (name changed), had multiple medical risks: Deep endometriosis and adenomyosis. Both conditions can cause severe pelvic pain. Medicines had failed to provide adequate relief.
Surgery was challenging because she also had severe osteoporosis. The condition had made her bones extremely fragile and increased the risk of fractures during the procedure, said Professor Dr Reeta Mahey, who led the gynaecology team along with Dr Swati Tomar.
The doctors performed a laparoscopic hysterectomy, a minimally invasive surgery to remove the uterus. The operation took about 90 minutes. The patient recovered well and was discharged on the third day.
Pro (Dr) Mahey said the patient’s short stature, low body weight and fragile bones required special precautions.
Instead of using the conventional position for gynaecological surgery, the team kept her flat to reduce the risk of fractures. The anaesthesia team also planned medication doses and airway management according to her low body weight and physical condition.
The procedure required close coordination between the surgical and anaesthesia teams. The anaesthesia team included Dr Parin Lalwani and Dr Choro Athiphro Kayina.
The surgery was carried out under the guidance of Professor Neena Malhotra, Head of the Department of Obstetrics and Gynaecology, and Professor K Aparna Sharma.
Endometriosis occurs when tissue similar to the lining of the uterus grows outside it. Deep endometriosis can affect structures within the pelvis and cause persistent pain while adenomyosis which occurs when similar tissue grows into the muscular wall of the uterus can cause painful periods, heavy bleeding and pelvic discomfort.
Treatment depends on the severity of the disease, the patient’s overall health, age, symptoms and reproductive plans.
“Hysterectomy may be considered in selected cases when other treatments are unsuitable or have not provided adequate relief. The procedure permanently ends the possibility of carrying a pregnancy,” said Prof (Dr) Mahey.
The patient’s recovery highlights how careful planning and teamwork can help doctors manage complex surgical cases involving multiple medical risks.
