Laparoscopic Assisted Vaginal Metroplasty

This presentation describes for the first time the successful performance of a laparoscopic-assisted vaginal metroplasty in a habitual aborter patient with a bicornuate uterus. A combined single puncture laparoscopy and operative colpotomy approach was used. Most symptomatic septate uteri can be treated by operative hysteroscopy. However, the correction of a symptomatic bicornuate uterus still requires abdominal metroplasty. The patient was 24 years old with four early midtrimester miscarriages. Habitual abortion work-up was normal except for a bicornuate uterus. A septate uterus with two distinct cavities, one uterine corpus and an indentation in the mid-fundal area was diagnosed by hysterosalpingogram and laparoscopy. The operating time was 2 hours and blood loss 150 ml. The patient was discharged at 48 hours and had an uneventful postoperative period. She is currently 28 weeks pregnant. This case presentation indicates that assisted vaginal metroplasty is an attractive minimally invasive surgical alternative to traditional laparotomy.