Bengaluru : Doctors at Fortis Hospital, Bannerghatta Road, Bengaluru, successfully removed more than 200 gallstones from a 71-year-old woman undergoing treatment for breast cancer, who was simultaneously battling a severe gallbladder infection and multiple co-morbidities. The highly complex robot-assisted surgery was led by Dr. Manish Joshi and supported by a multidisciplinary team of specialists.
The presence of over 200 gallstones in a single patient is exceptionally rare and is estimated to occur in fewer than one percent of reported gallstone cases worldwide. According to available medical literature, this is believed to be the first reported case in India involving the removal of more than 200 gallstones from a patient actively undergoing treatment for breast cancer.
The patient was admitted to Fortis Hospital with severe abdominal pain, nausea, and vomiting. Detailed clinical investigations revealed acute inflammation of the gallbladder caused by multiple gallstones. Further scans showed that stones had obstructed the common bile duct, resulting in bile duct swelling and increasing the risk of serious complications.
Compounding the complexity of the case, the patient was already managing several significant health conditions, including hypothyroidism, chronic lymphocytic leukemia, and right breast cancer, for which she was undergoing chemotherapy. Given her advanced age, ongoing cancer treatment, multiple co-morbidities, and severe infection, the case required extensive multidisciplinary evaluation and planning before surgery could be undertaken.
Before the surgical procedure, the gastroenterology team led by Dr. Ravindra B. S. performed an Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure to remove the bile duct stone and place a temporary stent to restore bile flow.
During surgery, doctors discovered that the gallbladder was severely infected and filled with pus, containing more than 200 gallstones. Considering the complexity of the condition, the surgical team proceeded with a robotic cholecystectomy using advanced Indocyanine Green (ICG) fluorescence imaging technology, enabling enhanced visualization and precision during the procedure.
The patient recovered well and was discharged in stable condition on the second day following surgery. She has been advised regular follow-up visits for continued monitoring and long-term care.
Commenting on the case, Dr. Manish Joshi, Director – Surgical Gastroenterology, Bariatric & Robotic Surgery, Fortis Hospital, Bannerghatta Road, said: “Gallstone disease affects approximately 10–15% of adults worldwide, and at Fortis Hospital, Bannerghatta Road, we perform nearly 400–500 gallbladder surgeries every year. However, most patients typically have only one to five gallstones. Discovering more than 200 gallstones in a single patient is extraordinarily rare and is estimated to occur in fewer than one percent of reported cases globally. With robotic-assisted surgery, we were able to operate with enhanced precision, improved visualization, and greater control in this challenging situation, contributing to a safer procedure and faster recovery for the patient.”
Sharing her experience, the patient said: “I was in severe pain and quite worried because of my existing health conditions. I am grateful to the doctors and medical team at Fortis Hospital for treating me with such care and confidence. Thanks to the timely treatment and advanced robotic surgery, I recovered smoothly and was able to return home in stable condition.”
Mr. Gautham C.B., Facility Director, Fortis Hospital Bannerghatta Road, added: “The successful management of this complex, high-risk case reflects the strength of our multidisciplinary expertise and advanced robotic surgical capabilities. This achievement, believed to be a first in India, highlights our commitment to leveraging cutting-edge technology and clinical excellence to deliver precise, patient-centric care even in the most challenging medical situations.”
The successful outcome demonstrates the growing role of robotic-assisted surgery in managing complex gastrointestinal conditions and reinforces Fortis Hospital Bannerghatta Road’s position as a leading center for advanced surgical care in India.