60 yrs female & 220 kgs in weight was brought to the ER of Trimurti Hospitals on 18/05/2017 in state of shock with only 60 SBP & respiratory distress. Patient was immediately shifted to ICU. Patient was stabilized with rigorous efforts of Dr. Shailesh Jadav & ICU team. On further investigations it was revealed that patient had bowel perforation which required immediate surgery. After detailed investigation & preoperative workout, Dr. Shailesh Jadav decided to concede inducing the patient. But the patient was so bulky that we had to merge two operating tables to maintain the patient on it. Jupiter Allied work station was used to anesthetize the patient. Surgery was done by Dr. D.P. Chikhalia & Dr. Amit bhuva. Bowel repair was done & 4 Lts of infected fluid was drained. It took around four hours for the entire procedure. Patient was shifted to ICU. On TPN. Bowel sounds are achieved & so was the first motions passed on day 5. Patient is recovering well & soon oral feed shall be started.