Bicorporeal Uterus: Laparoscopic Metroplasty

Bruno J. van Herendael, Benedikt Tas, Sanket Pisat, Anne Mie De Boodt, Patricia Duvivier
In: Female Genital Tract Congenital Malformations · 2014 · pp. 291–295 · doi:10.1007/978-1-4471-5146-3_28 · W566875722
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This chapter presents the laparoscopic metroplasty technique for unifying the bicorporeal uterus, detailing the incision, suturing, and recommended follow-up procedures.

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This chapter describes laparoscopic metroplasty for patients with a bicorporeal (bicornuate/double-cavity) uterus, outlining a high-level surgical technique to unify the uterine cavities by incising the median uterine walls and suturing them together in two layers. It reports that unification is feasible using laparoscopic entry, with potential advantages such as less bleeding, less discomfort, shorter hospital stay, faster return to work, and quicker restart of sexual activity. A second-look hysteroscopy and laparoscopy is ideally planned 6 months later, and cervical cerclage may be applied to reduce rupture of membranes and miscarriage risk during the second trimester, while the major caveat is that the exact indications for laparoscopic versus open metroplasty are not yet clear. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Aims: The aim of this chapter is to present the technique of laparoscopic metroplasty in cases of bicorporeal uterus. Brief description of the reviewed data: Unification of the uterine cavity by laparoscopic metroplasty is, nowadays, feasible. After establishing the laparoscopy, the two uterine cavities are opened by incising uterine wall at the median level using monopolar diathermy and scissors. Unification of the two cavities is achieved by suturing the uterine walls with interrupted sutures into two layers. A second look hysteroscopy and laparoscopy is ideally planned 6 months after. Cervical cerclage could be applied to avoid rupture of the membranes and miscarriage during the second trimester of pregnancy. Clinical implications: Laparoscopic metroplasty could be applied in patients with bicorporeal uterus if there is an indication for surgical repair of the anomaly. Patients could benefit from the classical advantages of the laparoscopic entry (less bleeding, less discomfort, shorter hospital stay, faster return to work and faster restart of sexual activity). Open issues for further research: The exact indications of laparoscopic and/or open metroplasty in the management of patients with bicorporeal uterus are not yet clear. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simon C, Pellicer A. Reproductive impact of congenital anomalies. Hum Reprod. 1997;12(10):2277–81. Sinha R, Mahajan C, Hegde A, Shukla A. Laparoscopic metroplasty for bicornuate uterus. J Minim Invasive Gynecol. 2006;13:70–3. Alborzi S, Asadi N, Zolghadri J, Alborzi S, Alborzi M. Laparoscopic metroplasty in bicornuate and didelphic uteri. Fertil Steril. 2009;92(1):352–5. Badawy SZ. Laparoscopic metroplasty in bicornuate and didelphic uteri. Fertil Steril. 2009;92(4):e53. Pisat S, Tas B, van Herendael B. Laparoscopic Strassman’s metroplasty for bicornuate uterus. Gynecol Surg. 2009;6(2):153–8. Brölmann HAM, Bremer GL. The laparoscopic Deschamps needle: the revival of an old concept. Gynecol Endosc. 2000;9:243–8. Brölmann HAM, Oei SG. The laparoscopic approach of transabdominal cerclage of the uterine cervix in case of cervical incompetence. Gynecol Endosc. 2009;9:191–4. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2015 Springer-Verlag London About this chapter Cite this chapter van Herendael, B.J., Tas, B., Pisat, S., De Boodt, A.M., Duvivier, P. (2015). Bicorporeal Uterus: Laparoscopic Metroplasty. In: Grimbizis, G., Campo, R., Tarlatzis, B., Gordts, S. (eds) Female Genital Tract Congenital Malformations. Springer, London. https://doi.org/10.1007/978-1-4471-5146-3_28 Download citation DOI: https://doi.org/10.1007/978-1-4471-5146-3_28 Published: Publisher Name: Springer, London Print ISBN: 978-1-4471-5145-6 Online ISBN: 978-1-4471-5146-3 eBook Packages: MedicineMedicine (R0)

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