Mrs. Sonia Dey (name changed), 49, was sent to Manipal Hospital Salt Lake after complaining of acute dysmenorrhea, persistent pelvic pain, and copious uterine bleeding. Her first ultrasound showed a right ovarian endometrium and several uterine fibroids of different sizes. Numerous doctors had previously refused to perform her procedure due to many complications. However, she underwent a complete laparoscopic hysterectomy under the guidance of Dr. Chanda Chowdhury, Consultant Obstetrics & Gynecologist, which resulted in a quicker recovery, less pain, and her discharge two days after the treatment.

One kind of cystic lesion that arises on the ovary as a result of endometriosis is called an ovarian endometrioma. It usually contains thick, aged, and changed blood, which gives it the distinctive look of a “chocolate cyst”. In response to hormonal changes during the menstrual cycle and recurrent bleeding, endometrial tissue—which normally borders the uterus—implants and develops on the ovary, accumulating old blood and causing cyst formation.

Mrs. Dey had a lengthy history of abdominal and pelvic surgeries, including laparotomy and Delorme’s operation, for rectal prolapse and imperforate anus. Additionally, she had a lower segment caesarean section (LSCS) through an abdominal incision made at the lower midline.

Dr Chanda Chowdhury, Consultant Obstetrics & Gynecologist, Manipal Hospital Salt Lake, said, “Dense intra-abdominal adhesions were expected due to her numerous prior surgeries, which made technical entrance and additional pelvic procedures difficult. She had hypothyroidism, impaired liver function, and irregular bleeding. At first, there was uncertainty over whether this surgery could be performed. However, I accepted the challenge, and she is doing well after a successful laparoscopic hysterectomy”.

Due to several complications, the surgery took more than three hours, but the patient is doing well and was released after two days.

Priyanka Dutta