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- W4323536750 abstract "The objective of this video is to highlight a safe and effective minimally invasive surgical treatment of a patient with endometriosis and a concurrent mullerian anomaly. This is the case of a 44-year-old nulliparous patient with a history of abnormal uterine bleeding and severe dysmenorrhea. Due to worsening of her symptoms that was refractive to medical treatment, she was referred to our tertiary care institution for further management. Pelvic examination revealed 2 cervices. A pelvic MRI demonstrated uterine didelphys with two separate uterine cavities and a double cervix. No urinary tract abnormality was appreciated. Intra-operatively, a large uterine manipulator was advanced into the right uterine cavity, ensuring that the colpotomy cup incorporated both cervices. At laparoscopy two separate uterine horns were noted and there were significant endometriotic deposits in the posterior cul-de-sac, along bilateral pelvic side wall and uterosacral ligaments. Extensive excision of the endometriotic deposits was performed including a deep infiltrating nodule in the posterior cul-de-sac. The hysterectomy was then completed in a stepwise manner, using the colpotomy cup housing both cervices as a guide and landmark for safe bladder dissection and for making the colpotomy. The uterus was removed vaginally and the vaginal cuff re-approximated using a barbed suture. The patient was discharged on the same day of her procedure. At her postoperative visit she was recovering well and had significant improvement in her pain. Endometriosis can occur concurrently in up to fifty percent of patients with uterine didelphys. Laparoscopic excision of endometriosis and total hysterectomy in the face of a mullerian anomaly such as uterine didelphys is safe, feasible, and can achieve good surgical outcomes and improvement in patient’s symptoms." @default.
- W4323536750 created "2023-03-09" @default.
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- W4323536750 date "2023-03-01" @default.
- W4323536750 modified "2023-09-27" @default.
- W4323536750 title "Robotic-assisted total laparoscopic hysterectomy and excision of endometriosis in a patient with uterus didelphys" @default.
- W4323536750 doi "https://doi.org/10.1016/j.ajog.2022.12.255" @default.
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