Patrick Deuel, 43, a Nebraska man who once weighed 1,072 pounds (486kg).

A Nebraska man who once weighed 1,072 pounds (486kg) has dropped another 81 pounds (37kg) in surgery that removed a chunk of fat, skin and fluids hanging from his waist.

Patrick Deuel, 43, weighed in at 400 pounds (181kg) after the operation on Tuesday at a hospital in Sioux Falls, S.D.

Doctors performed the surgery because the extra flesh made it hard for Deuel to walk.

Deuel weighed 1,072 pounds (486kg) and was dying of heart failure when he checked into the hospital in Sioux Falls in June 2004.

He dropped 457 pounds (207kg) in seven months, crediting most of the loss to exercise and diet, although he also had gastric bypass surgery in 2004.

Before he entered the facility, he hadn't left his home in seven years and was so big that workers had to cut a hole in his bedroom wall to get him out.

A special ambulance with extra-wide doors and a ramp-and-winch system was used to get him to hospital.

Deuel has said he plans to make public appearances to tell his story once he is more mobile.

Deuel's surgeon says the most recent operation means he could lose even more weight through walking and exercise.