Background: 50-year-old patient who is Para 2 (1 caesarean section, 1 vaginal delivery) with normal cervical screening tests. The patient was referred with heavy and painful periods, ultrasound showed fibroid bulky uterus. The patient is known to have a history of hydrocephalus requiring ventriculoperitoneal shunt. The shunt can be seen with the laparoscopy images.
Procedure: Laparoscopic subtotal hysterectomy, bilateral salpingectomy (removal of both tubes), morcellation of uterus in Espinar bag (cutting the uterus into small pieces in a contained bag to achieve keyhole approach), and cystoscopy (camera in the bladder).
Findings: A large fibroid uterus measuring about 16–18-week size uterus, right ovarian cyst. The ventriculoperitoneal shunt was seen in the peritoneal cavity.
Histopathology results: The uterus measurements were 11.5, 11 and 4cm. There was a right ovarian cyst that was removed at the same time. Histology of the uterus confirmed benign fibroids with calcification.
Recovery: Patient recovered well with no concerns.