**1. Introduction**

In the past, laparoscopic surgery was considered a relative contraindication in obese patients. However, since the feasibility of performing laparoscopy on the obese patient was first published in the gynecologic literature in 1976 [1–3], there have been increasing evidence that obese patients benefit from laparoscopic surgery compared to the abdominal approach [4, 5]. However, data on patients with a BMI of 40 are limited.

On the other hand, laparoscopic hysterectomy of a huge uterine mass is technically challenging, but it has been proven feasible and safe procedure if performed by experienced surgeons regardless of the size, number, and location without much morbidity [6–9].

However, operating a large uterine mass in a super-morbidly obese woman laparoscopically is technically far more challenging for surgical and anesthetic management. Still, it is the best option for the patient as it allows early mobilization and spares them from tumultuous postoperative morbidity from open surgery. We are reporting a case of total laparoscopic hysterectomy for a large uterine mass of 24 weeks gestation in a super morbidly obese woman with a body mass index of 60 kg/m2 . To our knowledge, this combination of sizeable uterine mass in a super-morbidly obese woman successfully managed laparoscopically is rarely reported.
