City doctors remove giant ovarian cyst weighing 20kg with minimal incisions

MUMBAI: When a 44-year-old woman with severe breathlessness, inability to walk and a huge abdomen turned up at Lilavati Hospital, Bandra, on Monday morning, she was immediately admitted for further investigations.
Scans revealed a huge mass arising out of her right ovary. “It was a very large ovarian cyst,” said senior gynaecologist Dr Kiran Coelho, who operated on her on Wednesday after ruling out cancer.
The medical team claims this is the largest cyst ever removed without an open surgery; they used the minimally invasive method of laparoscopy to access the inside of the abdomen and pelvis with small incisions of less than 1.5cm.
The patient’s cyst weighed 20kg and doctors drained 16.4 litres of fluid from it. “This is the largest cyst removed totally laparoscopically in around 45 minutes,” said Dr Coelho. The last ‘giant cyst’ that was laparoscopically removed was 19kg with 15.4 litre of fluid, according to an article published by the All India Institute of Medical Sciences, Patna, in the peer-reviewed medical journal, Cureus, in January 2023.
The usual practice is to remove large cysts with a cut across the abdomen or combine laparoscopy with a partial cut. But once the patient’s investigative reports showed the cyst was benign, doctors removed it laparoscopically so that the patient could heal faster. “The patient was made to walk on the evening of the surgery and started on full diet the next day,” said Dr Coelho, adding that keyhole incisions cause “minimum pain and discomfort”.
The patient was discharged on Friday, and is likely to go back to her home in Kolkata soon. Her family said her abdomen started swelling up six months back, and at that time a local doctor had said there is no cause for worry. But the abdomen kept growing till she found it difficult to breathe and walk. As the patient didn’t want an open surgery, the family checked the internet for laparoscopic surgeons and landed in Lilavati Hospital.
A doctor from a public hospital said ovarian cysts are not uncommon, but they rarely grow to giant proportions as scans catch them early. Dr Niranjan Chavan from BMC-run Sion Hospital said, “Every month, we get a couple of large cysts filled with about five litres of fluid. We get patients from Bihar and Uttar Pradesh as well.”
Cysts are usually seen in menopausal women or adolescent girls. “Many women don’t suspect anything is wrong till late because they only have a dull abdominal ache and their periods are regular. Unfortunately for some, the ovarian mass could be cancerous and in that time, spread to other organs,” said Dr Chavan.