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Journal of Robotic Surgery

, Volume 4, Issue 2, pp 137–140 | Cite as

Robot-assisted laparoscopic surgery for a rudimentary uterine horn with two non-communicating cavities

  • Jan PerssonEmail author
  • Thomas Bossmar
  • Pia Teleman
Case Report

Abstract

Due to severe dysmenorrhoea a 29-year-old woman, gravida 2 para 2, was diagnosed with a unicornuate uterus and a rare variety of a rudimentary uterine horn associated with two separate non-communicating cavities. Increasingly intense dysmenorrhoea, refractory to medical treatment, motivated fertility-sparing surgical treatment. A da Vinci S-HD robot was side-docked to facilitate simultaneous vaginal access during surgery. After sacrificing the left uterine artery for hemostatic reasons, the rudimentary horn with one cavity was resected. Guided by vaginal ultrasonography we then completely resected the second cavity located deep in the myometrium without entering the cavity of the functioning hemiuterus. Finally the uterine defect was sutured in two layers. Surgery and postoperative course were uneventful. At 4-month follow-up, dysmenorrhoea was alleviated, and 3 months later the patient had an early intrauterine pregnancy. We believe the precise dissection capabilities of the robot facilitated in particular resection of the second, deeply located cavity and its multilayer reapproximation by sutures. A video of the procedure is provided.

Keywords

Robot-assisted surgery Atretic uterine horn 

Notes

Disclosure

Jan Persson is a proctor for surgery with the da Vinci system. The other authors have no disclosures.

Supplementary material

MPG 196682 kb

References

  1. 1.
    Acién P, Acién M, Sánchez-Ferrer M (2004) complex malformations of the female genital tract. New types and revision of classification. Hum Reprod 10:2377–2384CrossRefGoogle Scholar
  2. 2.
    Acién P, Acién M, Fernández S (2008) Segmentary atresias in Müllerian malformations. Eur J Obstet Gynecol Reprod Biol 141:188–189CrossRefPubMedGoogle Scholar
  3. 3.
    Heinonen P (1997) Unicornuate uterus and rudimentary horn. Fertil Steril 68:224–230CrossRefPubMedGoogle Scholar
  4. 4.
    Anderberg M, Bossmar T, Arnbjornsson E, Isaksson J, Persson J (2009) Robot-assisted laparoscopic hemihysterectomy for a rare genitourinary malformation with associated duplication of the vena cava. A case report. EJPS 20:206–208Google Scholar
  5. 5.
    Persson J, Kannisto P, Bossmar T (2008) Robot-assisted abdominal laparoscopic radical trachelectomy. Gynecol Oncol 111(3):564–567 Epub 2008 Jul 11CrossRefPubMedGoogle Scholar
  6. 6.
    Fedele L, Bianchi S, Zanconato G, Berlando N, Bergamini V (2005) Laparoscopic removal of the cavitated noncommunicating rudimentary uterine horn: surgical aspects in 10 cases. Fertil Steril 83:432–436CrossRefPubMedGoogle Scholar
  7. 7.
    Theodoridis T, Saravelos H, Chatzigeorgiou N, Zepiridis L, Grimbizis GF, Vavilis D, Loufopoulos A, Bontis J (2006) Laparoscopic management of unicornuate uterus with non-communicating rudimentary horn (three cases). Reprod Biomed Online 1:128–130CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd 2010

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyLund University Hospital, and Lund UniversityLundSweden

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