Doctors at a city hospital have successively removed a tumour of the size of a "34-week foetus" lodged inside a woman's womb using a combination of two operation techniques, authorities said today. The 47-year-old patient had approached the Sir Ganga Ram Hospital (SGRH) here in January with complaints of abdominal pain and menorrhagia (abnormally high bleeding at menstruation) over the last 10 years, a hospital spokesperson said. "On her abdominal examination, a large firm mass was felt corresponding to 34 week's gravid uterus (foetus of 34 weeks in womb). "The investigations at SGRH revealed that the tumour had grown into a giant one, sized 23 cm x 23 cm x 16 cm and weighing 4 kg. It was occupying the space from depth of the pelvis up till four inches below the breast bone and was adjoining the liver," the hospital said in a statement. The case was published recently in the Journal of Obstetrics & Gynaecology Research by the Department of Minimally Invasive Gynaecology, SGRH, which talks about the "unique removal and management of the giant cervical tumour by using the 'hybrid technique' - mixture of two techniques, it said. "Our case is unique in many ways. Firstly, the huge size of the tumour, its rapid growth and its management laparoscopically. Moreover, this case amazed us because in spite of knowing about the tumour, no active management was done till date," Debasis Dutta, Senior Consultant, Department of Minimally Invasive Gynaecology, Institute of Obstetrics & Gynaecology at the hospital, said. The size of the tumour, its precarious position and chances of it being cancerous (high chances of bleeding) made its removal challenging, the spokesperson said. "The tumour had to be removed in total, and at the same time, the blood loss had to be reduced and limited," he said. "Therefore, a hybrid technique was employed in which laparoscopic hysterectomy was planned for minimising the blood loss, and laparotomy was performed for total removal of the tumour along with the uterus, owing to high suspicion of malignancy in the mass," the statement said. "The procedure was completed in three hours and estimated blood loss was 500 ml. The weight of the cervical fibroid (mass) was 4 kg," it said. According to Kanika Chopra, Department of Minimally Invasive Gynaecology at the SGRH, "Due to the use of the hybrid technique, there was no injury to adjoining vital organs like the bladder, the ureter or the bowel loops as seen in other similar cases reported previously in literature."