Total Laparoscopic Hysterectomy Performed on a Patient With Moyamoya Disease

Minimally invasive gynecologic surgery in patients with Moyamoya disease (MMD) has not been reported. Here, we present a case of total laparoscopic hysterectomy (TLH) in a patient with MMD. A 39-year-old woman presented with a history of cerebral infarction due to MMD. She had experienced a stroke 4 months prior and was undergoing rehabilitation for hemiplegia. She developed severe anemia due to hypermenorrhea. General anesthesia has a high risk of stroke recurrence postoperatively if a short time has passed since stroke onset. Seven months after the stroke, the patient underwent TLH. The postoperative course was uneventful. This is the first report of gynecological laparoscopic surgery in a patient with MMD. Safe laparoscopic surgery is possible under attentive anesthesia and perioperative management.