The 9.2 kilo uterine fibroid

When doctors say “We removed a fibroid weighing so many kilos” They usually refer to a hysterectomy, that is, removing the fibroid with everything and the uterus… But this 9.2 kilogram fibroid was operated on by myomectomy, that is, preserving the uterus . We believe it is the largest myomectomy ever performed. Could you help us confirm this?

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Introduction

How about Good afternoon. Today I want to tell you about a fibroid or a surgery we did with a 9 kilo 200 gram fibroid. We had already gone up the previous time, last year a 10 kilo surgery but unfortunately we had to remove the uterus from that patient because it could not be saved, the uterus was completely involved in the fibroid but now this surgery that we want to show you has particularities specific, one of them is that the patient is a Jehovah’s Witness and the other is that it was a 9 kilo 200 gram tumor but we managed to preserve the uterus.

We have investigated a little as we said in that video of the 10 kilos and the largest fibroid that has been removed in history was 66 kilos but it was post mortem, in a surgery probably a patient after dying to see what the cause was. and it was found that it was a fibroid tumor and the other was 33 kilos. In this case they also removed the uterus. Why do we mention this to you? Because we are not sure if this is the largest fibroid that has been removed that can preserve the uterus.

If you, the subscribers who are with us at Creafam, help us find information and tell us, we would appreciate it, to see if this is a record… Surely, at least in Mexico, yes, of the largest myoma that has been removed and that can be preserved The uterus. Relatives who have doctors or medical students, let’s see if they can investigate and tell us, send us a message, we would love for you to give us information so we can search a little deeper.

Elise's Testimony

Dr. Valdés: Good morning, look, the patient we operated on with 9 kilos of fibroid has returned, look at the uterus, how good it looks, it is still a little bit grown because obviously, being a 9 kilo surgery, it was very displaced, but if we look at the The uterus already measures 94 millimeters or 9 and a half centimeters, which is relatively normal. Right now I will talk to them but it is super interesting because they can see how beautiful the uterus looks even though we removed a 9 kilo tumor. Abdominally we can also visualize the uterus, the uterus is clearly visible, it is obviously still above the umbilical scar but that is normal because as it is a tumor that moved the uterus upwards, well now it is returning, let’s say, to its normal size. , she is contracting but she looks perfect, she will surely be able to get pregnant very soon.

What’s up good morning. Look, I’m here with Elise, my little patient Elise Vázquez, they came from the State of Mexico, right?

Elise: Well, I found out about this in 2020 in a normal check-up or rather I was exercising and I felt something that was not normal in my body, so we made the decision to do a check-up. The gynecologist who treated me told me that he had two fibroids but he told me that as long as they didn’t grow they wouldn’t give me the problem, so we were watching them, monitoring them to make sure they didn’t grow. Initially they didn’t grow, then the pandemic came and we were… Well, we didn’t move, we didn’t go out, we didn’t go for check-ups, nothing. I was only visualizing that they were not growing, then I started to feel like my belly was bigger and getting bigger. I saw another gynecologist and he told me that he had what I already knew, 2 fibroids, but that they had to operate on me and that they had to remove my uterus. When I found out that they had to remove my uterus, it’s not something simple, right? It is not an easy thing for a woman to say “Well, I’m going to take it away from you.” So for me it was a difficult situation that I was looking for another option to tell me that they could remove my fibroids but that they could save my uterus, so I took on the task of searching and searching for information and in one of those searches I found you and it took me in making the decision to come. In this process this year, the fibroids starting last year in November began to grow excessively, it was already a continuous growth, each month it was a growth more and more and more to the point that I arrived here with a fibroid of 9 kilos that I didn’t even know the size of that tumor. Well, work was already difficult for me, I could no longer go to drop my son off at school, I could no longer do practically anything other than being at home and doing a little bit and going to bed, so it was a complicated situation, I looked for another option, I couldn’t find And I came with you and the surprise I got was that since my uterus was not compromised, they were able to remove it completely and my uterus was there.

It was a complicated situation because as Jehovah’s Witnesses we do not accept blood and we were looking for an option where they had the recovery machine and apart from that they would remove it without complications because I had already had a complication because they had operated on me elsewhere and they did not do it. They were able to remove it… So I went, they opened it for me, they didn’t take it away and then it was a complicated situation. I decided to come with you because of the confidence that the videos gave me that I listened to the operations that you had already performed and that you also had the recovery machine, so for me it was something very similar… I am very grateful to you because you took it away from me and They didn’t give me blood and right now I feel perfectly fine. It was a situation of trust, really when I already knew that I was coming to have surgery here I was already confident, first that they were not going to give me blood and second that they were going to do everything possible not to give me blood and still remove it. the tumor, then I came confident, I came calm, I was not afraid like last time when I was quite afraid, now I came calmer because I knew that you had the recovery machine and I also had confidence that they were going to remove the tumor. They all become a team and together they make decisions and solutions to whatever is presented to them.

I really didn’t know what they were going to find or how big they were going to find, what difficulties were going to be presented to you, but I did know and I was confident that, as you had told me, together they were going to throw a lot and together They were going to make the best decisions to be able to withdraw it. Since I entered the operating room and Dr. Claudia was with me, the treatment gave me a lot of confidence, all the support they gave me from the beginning because I have a very great fear of needles, but too great and when she came in I explained it to her, the fear that I had and she gave me a lot of confidence and I can tell you that I didn’t even feel the pain they gave me because the confidence they gave me from the beginning was great.

Dr. Valdés: Ok, now we are going to move on to your husband, Juan Carlos, you were able to see the tumor because I showed it to you, right? During the surgery, we came out to show you. Seeing that tumor and seeing how this Elise is doing right now. What could you say?

Juan Carlos: Yes, the change has been too much, I saw the tumor… Two tumors and one that was growing apart, the truth is I was very scared when I saw them because I didn’t imagine something so, so big, but when she came out of surgery and they told me that they had used the recuperator and that I hadn’t bled as much, that I was fine, I was calm, so that gave me even more confidence. I have seen how she has been recovering, in her day-to-day life, how she has handled it and the truth is that I really like that because she wants to say that the surgery was a success, everything was fine.

Conclusions

He had 13.20 hemoglobin before surgery and 340,000 platelets. Although it was a surgery that only bled relatively 1 liter, it dropped to 7.7, this was the post-surgical check that we did and see how the platelets also dropped and this is the check that brings us now a month and a half after the surgery, see the Hemoglobin 14.3 has already recovered and 441,000 platelets so she is practically normal.

Practically, I want to say the cellular recuperator like this, it is as if it were an air filter or like when you put the water in… The devices they sell now that filter the water, what it does is: The blood that we are removing from the surgery we put it into a machine that has filters to purify that blood and then they give it oxygenation and transfer it to a bag to later transfuse it, in fact if you look at the video there is even Dr. Monsalve, my partner and my companion who helps us in the surgeries together with Dr. Carlos Cortés who is another subspecialist in oncological surgery but Dr. Monsalve is with an aspirator recovering all the water and blood that is coming out into the cavity during the surgery because it is very important in These patients recover as much of the blood as possible so that it can be put into the recovery unit.

I’ll give you an example, I remember perfectly well this patient bled a 400 liter or so and we were able to recover from that 400 liter or so 750 milliliters, which is practically as if they were two globular packets which was what we transfused her directly in that same procedure. during the surgical process. So please call us, come. We can solve the problem of your fibroids.

We are sure that at least in Mexico it is the record for the largest myoma operated on by myomectomy preserving the uterus, but we want to thoroughly investigate whether it is a Guinness record or a world record.

Dr. Arturo Valdés
Dr. Arturo Valdés
Reproductive Medicine and Gynecological Endocrinology
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