Successful Laparoscopic Myomectomy in Giant Myoma

A giant uterine fibroid is a rare tumor of the uterus. Uterine leiomyomas are the most common type of a benign tumor that arises from the female pelvis. Uterine leiomyoma is a smooth muscle tumor. Its prevalence is more in reproductive age group and decreases after menopause. They are rare in adolescents. In reproductive age group, the preferred mode of management of fibroid is myomectomy. For large myomas, the role of laparoscopic myomectomy is still controversial. Laparoscopic myomectomy for giant myoma is technically challenging and should be performed by an experienced surgeon. We herein report the case of a 32-year-old unmarried girl who visited our hospital with the complaint of progressive abdominal distension and discomfort from the past 4-5 months. Ultrasonography was done, and it showed a markedly enlarged uterus containing a 16 cm × 17 cm subserosal fibroid and 3 cm × 4 cm intramural fibroid. Magnetic resonance imaging suggestive of three myoma, one sub serosal myoma at fundal region of 11.2 cm × 9.6 cm × 14.2 cm, second intramural fibroid in the lateral wall of the uterus of 3 cm × 3 cm and a small submucosal fibroid of dimension 1.1 cm × 0.9 cm × 0.8 cm. Laparoscopic myomectomy was planned and completed successfully with no intra- and postoperative complications. Intraoperative finding was suggestive of 20 cm × 20 cm × 18 cm fundal fibroid and 2 cm × 3 cm lateral wall fibroid. The defect was closed using V-lock suture in two layers. The myoma was removed by tissue morcellator. In the literature, only a few cases reported of successful removal of giant myoma by laparoscopy.