HT Correspondent, Hindustan Times Mumbai, December 05, 2009
Two city doctors have successfully removed 24 fibroids, weighing 2.9 kgs, from a woman’s uterus through a keyhole incision using a unique instrument developed by a local biomedical engineer. The patient, Pooja Sharma (31) (name changed), who had lost hope of having a child after three miscarriages, can now look forward to conceiving again.
After being diagnosed with multiple fibroids in 2003, the call center employee went in for an open abdomen surgery. Her gynaecologist abandoned the procedure midway fearing damage to the uterus owing to the innumerable fibroids and heavy bleeding.
She approached obstetrician Dr. Piyush Goyal, who decided to perform the surgery laproscopically (through a small cut) to save her uterus. “Tests showed us six musk melon-sized fibroids but when we put the laproscope in we saw many smaller ones too,” said Dr Goyal, who specialises in endoscopic gynaecological surgery. On November 20, Gynaecologist Dr Piyush Goyal removed 24 fibroids from Sharma’s uterus at a private hospital in Dadar.
“The fibroids were embedded in the walls of the uterus and we had to carefully reconstruct the uterus and restore functionality so that she can conceive again,” said Dr Goyal.
To remove so many fibroids in one go, doctors used a special equipment, Fibro-extract, developed by them and biomedical engineer Sandeep Kulkarni. The equipment has a rotating blade that cuts off fibroids.
“In equipments imported from US or Germany, one has to change the blade after every 2-3 fibroids. The Fibro-extract blade can be used to remove multiple fibroids. It can be sharpened, sterilised and re-used,” said Dr Goyal, adding that Fibro-extract costs Rest 1.5 laky as compared to Rest 7 laky for the imported equipment. Sharma has no idea about the intricate details of the surgery but she is thrilled to be fibroid-free.
“I am waiting to have a baby,” she said.
Doctors did not suspect anything amiss with Anjali Khedekar, 34, till she had her third miscarriage in three years. Last week, when doctors conducted a hysteroscopy on Khedekar they found that that she had two uteri, one of which was not functional. “I went to more than 10 doctors to check what was wrong. It was only after the third miscarriage that doctors told me I had a uterus growth abnormality. But they said I should just keep trying to conceive,” said Khedekar, an accountant. After the fourth miscarriage last year, Khedekar was referred to Dr Piyush Goyal MD, Chief of the Advanced Hysterolaproscopy Surgical Unit, Agarwal Nursing Home at Bandra, Mumbai, India.
“While the other doctors had opined that she did have a developmental abnormality called mullerian abnormality in her uterus, they were not able to detect exactly what was wrong. Some muellerian abnormalities do not always need surgery, but in this case, the woman had four miscarriages in 10 to 11 weeks of pregnancy,” said Dr Goyal. Dr. Piyush Goyal conducted the surgery hysteroscopically with the guidance of a laproscopic camera last Friday. “When we inserted the camera, we saw that her uterus had not developed completely. She has two uteri, one side which was completely developed with a fallopian tube and the other which was non-functional, albeit with a tube,” said Dr Goyal.
Dr. Goyal said the reason why she had so many abortions, was that her one functional uterus had a very narrow cavity. “I used an instrument with electro surgical current to rip off the excessive muscles in the cavity and make it into a triangular uterus. This procedure will reduce the chances of further abortions and help pregnancy,” said Dr Goyal. “Increasing the cavity of the uterus via metroplasty procedure helps the woman to continue the pregnancy for about seven-eight months,” said Dr CN Purandare, Consultant Gynaecologist and Obstetrician.