Mumbai doctors have successfully performed a landmark monportal endoscopic spine surgery on a 45-year-old woman who presented with severe back pain and marked loss of mobility. The patient was “super obese”, weighing 120 kg with a BMI of 52, which placed her at significant surgical risk.
This case makes it the highest documented BMI in India at which this Interlaminar endoscopic technique has been performed safely.
The 45-year-old woman, originally from India and currently living in Germany, returned home for her annual visit and developed sudden, severe back pain soon after arrival. The pain intensified to the point that she could barely stand or walk.
Initial evaluation confirmed an L4–L5 disc herniation with severe nerve-root compression. Although such cases usually respond well to surgical treatment, but she was not being offered surgical option due to her weight.
She remained bedridden for nearly two months without improvement, and the prolonged immobility raised concerns about losing her job in Germany since she was unable to travel back.
She then sought care at Jaslok Hospital, where the endoscopic spine team assessed her case. The surgeons explained that monportal endoscopic spine surgery, which requires an incision of less than 1 cm, is safe and feasible even for patients with complex body types, making her weight no barrier to treatment.
A review of medical literature confirmed that she is likely the highest-BMI patient in India to undergo this endoscopic procedure successfully.
The surgery was performed successfully by Dr Manish Kothari and the Anaesthesia for the surgery was looked after by Dr Rajashree Deopujari, additional director Anaesthesiology and Dr Anuraj Jain, consultant, Anaesthesiology. She was discharged the following day with significant pain relief.
After recovery, she began a structured weight-loss programme involving diet and exercise and lost around 20 kg over the next two months. She has now returned to Germany with her parents to resume work and continue her health journey.
Dr Manish Kothari, consultant Endoscopic Spine Surgery, said, “Operating on a patient with such a high BMI required constant attention to subtle anatomical variations and careful instrument navigation. The monportal endoscopic approach gave us the precision and flexibility to adapt at every step, ensuring safe decompression of the nerve with minimal SCAR. Seeing her regain mobility so quickly is a powerful reminder of how surgical expertise combined with advanced technology can make a real difference in challenging cases.”
Dr Milind Khadke, chief medical officer, said, “This patient had been considered too high-risk for surgery due to her weight, yet at the hospital we were able to offer a safe and effective minimally invasive solution. Cases like hers demonstrate the level of expertise and confidence our team brings to complex spine care. Seeing her regain mobility so quickly reinforces how advanced endoscopic techniques can provide new possibilities for patients who were previously considered inoperable.”