Weekly Monday Surgery | Professor Xu Tianmin: Laparoendoscopic Single-Site Total Hysterectomy plus Bilateral Salpingectomy

Case Summary

Patient, female, 49 years old.

Chief Complaint

Recurrent lower abdominal distending pain for 3 months.

History of Present Illness

Three months prior to admission, the patient developed persistent lower abdominal distending pain without obvious inducement and received no medical intervention. One month ago, the abdominal distension and pain failed to relieve, accompanied by frequent micturition (more than 10 times per day). She sought care at a local hospital, and gynecological transvaginal ultrasound revealed an enlarged uterus measuring 12cm×10cm×10cm with an 8cm×8cm myoma nodule at the uterine fundus, and surgical intervention was recommended. The patient was admitted to our department for definitive surgical treatment with the preliminary diagnosis of uterine fibroids after outpatient evaluation.

Past Medical History

Unremarkable; two previous cesarean deliveries.

Menstrual History

Menarche at age 13; regular menstrual cycles of 28–32 days, menses lasting 4–6 days. Last menstrual period: October 2, 2025.

Obstetric and Gynecologic History

Gravida 3, Para 2; 2 cesarean sections, 1 induced abortion.

Gynecologic Examination

Normal vulvar development; patent vagina with moist, elastic vaginal mucosa and a small amount of white discharge without obvious odor. Cervix hypertrophic with a relatively smooth surface. The uterus was enlarged to 12cm×10cm, with the fundus palpable 3 fingerbreadths above the pubic symphysis; a hard, smooth nodule approximately 8cm in diameter was detected at the fundus. The uterus had fair mobility with mild tenderness. No abnormal masses or tenderness were palpated in bilateral adnexal regions.

Auxiliary Examinations

Transvaginal Ultrasound (Our Hospital, October 12, 2025):Anteflexed uterus measuring 12.4cm×10.3cm×10.2cm; endometrial thickness 0.4cm; heterogeneous myometrial echotexture with multiple well-circumscribed hypoechoic lesions with uniform internal echoes. The largest lesion located at the fundus measured 8.7cm×8.1cm; CDFI showed blood flow signals at the periphery and within the nodule.

Admission Diagnosis

Uterine fibroids

Surgical Procedure

Laparoendoscopic Single-Site Total Hysterectomy plus Bilateral Salpingectomy

Surgeon Profile

Professor Xu Tianmin

Vice President of the Second Hospital of Jilin University, Bethune Medical CampusExecutive Dean of the Department of Obstetrics and Gynecology HospitalDirector of the Teaching and Research Section of Obstetrics and Gynecology

Standing Committee Member, Obstetrics and Gynecology Branch of Chinese Medical Association
Standing Committee Member, Chinese College of Obstetricians and Gynecologists
Committee Member, Gynecologic Oncology Branch of Chinese Medical Association
Director, Jilin Provincial Quality Control Center for Obstetrics and Gynecology
Associate Editor-in-Chief, Maternal & Child Health Care of China
Standing Committee Member, Chinese Society for Colposcopy and Cervical Pathology, China 优生 Science Association
Recipient of the National Outstanding Contributor Award for Improving Medical Services (National Health Commission)
Changbai Mountain Leading Talent of Jilin Province
Second Prize, National Micro-Course Teaching Competition
Third Prize (Senior Professional Title Group, Curriculum Ideology Category), 3rd National University Teacher Teaching Innovation Competition
First Prize, Jilin Provincial University Teacher Teaching Innovation Competition
First Prize of Jilin Provincial Science and Technology Progress Award (Principal Investigator)

Professor Xu specializes in minimally invasive surgery including laparoscopy and hysteroscopy, as well as open gynecologic surgery. She pioneered and promoted laparoendoscopic single-site surgery in Jilin Province. Her clinical expertise covers standardized diagnosis and treatment of gynecologic malignancies, complex refractory gynecologic disorders, and common benign gynecologic diseases.

Editor: Qinghuan

Reviewer: Ma Ye