Outstanding Young Surgeon | Liao Lichuan: Giant Cervical Leiomyoma – Laparoscopic Total Hysterectomy plus Bilateral Salpingectomy and Ureterolysis

Patient Medical History Summary

The patient is a 52-year-old married female.

Chief Complaint

Routine transvaginal ultrasonography in our outpatient clinic on Feb 31, 2025 revealed endometrial thickness of approximately 11.2 mm.

A heterogeneous slightly hyperechoic lesion measuring 102mm×72mm×84mm was detected posterior to the right uterus and adjacent to the parametrium, highly suggestive of uterine leiomyoma.

Disease Course

The patient presented with abdominal distension; no menorrhagia, prolonged menstruation or menstrual cycle irregularity. No chills, fever, nausea, vomiting, cough, expectoration or diarrhea. No frequent micturition, urgent micturition, dysuria or dyschesia/dysuria with difficult voiding.

No remarkable past medical history, personal history or family history.

Obstetric History

Gravida 3, Para 2: two vaginal deliveries and one induced abortion; two living children (one daughter, one son).

Menstrual History

Menarche at age 17, menstrual duration 7 days with cycle length 25–28 days. Last menstrual period (LMP): Jan 9, 2025. No dysmenorrhea, regular menstruation with moderate menstrual blood volume.

Auxiliary Examinations

Pelvic MRI: Mass-like abnormal signal lesion (84mm×92mm) at right posterior pelvic parametrium with smooth margin and clear boundary, compressing adjacent uterus and colon with displacement. Isointense on DWI sequence, slightly hyperintense on ADC map and slightly hypointense on eADC map. Imaging findings favor benign neoplastic lesion, further examination recommended. All other lab and auxiliary test results were unremarkable.

Therapeutic Regimen

Surgical Procedure

Laparoscopic total hysterectomy + bilateral salpingectomy + right ureterolysis

Key Surgical Steps

Ureter localization and preservation: Precisely trace the anatomical course of ureter; blunt dissection is adopted to prevent thermal injury from electrocoagulation.
Incision of leiomyoma pseudocapsule: Monopolar electrocautery hook is used for curvilinear cut along the pseudocapsule of fibroids, keeping safe distance from uterine vessels; intermittent cutting plus coagulation is applied to reduce intraoperative hemorrhage and maintain clear surgical field.

Intraoperative Details

Operation duration: 1 hour and 50 minutes; Intraoperative blood loss: 100 mL.

Postoperative rehabilitation management: Self-formulated traditional Chinese medicine for abdominal wet compress, point application, auricular point pressing and foot bath to accelerate enhanced recovery after surgery (ERAS).

Postoperative recovery: Passed flatus on postoperative day 1; urinary catheter removed on postoperative day 2; routine blood test and biochemical examination showed no abnormality on postoperative day 3; hospital discharge on postoperative day 5.

Pathological Report (Dated Feb 8, 2025, Specimen: total uterus and bilateral fallopian tubes)

Uterine leiomyoma with hydropic and myxoid degeneration, focal cellular hyperplasia;
Cervix: chronic cervicitis;
Endometrium: secretory phase morphology;
Bilateral fallopian tubes: chronic salpingitis with one side mesosalpinx Morgagni cyst.

Introduction of Surgeon

Liao Lichuan

Associate Chief Physician, Department of Gynecology, KaiZhou District People’s Hospital, Chongqing

Member, Clinical Group, 3rd Reproductive Medicine Branch, Chongqing Medical Association
Member, Obstetrics and Gynecology Committee, Chongqing Association of Integrative Medicine and Western Medicine
Committee Member, Cervical Lesion Branch, Chongqing Maternal and Child Health Association
Member, Youth Committee, Chongqing Society of Obstetrics and Gynecology
Committee Member, 2nd Reproductive Medicine Committee, Chongqing Medical Doctor Association

Honors & Awards

Winner of Chongqing Women Model Award; Second Prize & Most Popular Teacher Award in Youth Teaching Contest of Teaching Hospital Affiliated to Chongqing Medical University; Excellent Doctor & Outstanding Physician awards. She has repeatedly shared typical surgical videos and clinical cases at academic conferences and won multiple prizes in clinical case and surgical video competitions. Centered on patient benefits, she pursues clinical excellence and commits to providing high-standard professional medical care for women’s health.

Editor-in-charge: Qinghuan

Examiner: Ma Ye