1655 Laparoscopic Unification of Non Communicating Horn with Hemi-Uterus

Abstract

Video Objective To demonstrate new idea of laparoscopic unification of functional non – communicating horn with hemi-uterus instead of removal to improve obstetric outcome in future. Setting an academic tertiary care hospital. A 14-year-old girl presented with complaints of pain in lower abdomen, on and off for 2 months. Her previous 2 cycles were regular; she had cyclic dysmenorrhoea since her menarche which was now become intolerable and continuous. Secondary sexual characteristic was normal. hormone profile normal and on local examination normal external genitalia found. A thin dilator passed into vagina to confirm patent vagina. ultrasound suggested a unicornuate hemi uterus and right non communicating horn with a turbid collection. MRI also confirm the same. Interventions On Hysteroscopy a small right uterine cavity with only one ostium on right. Cervical canal was normal with normal crypts. vagina also normal and spacious. On diagnostic laparoscopy: A unicornuate right hemi- uterus with a non-communicating left horn was noted on the right side of the round ligament, tube and ovary were seen normal with small hemi-uterus. On the left, small uterine horn seen with absent tube but normal ovary and round ligament attachment. First, we were planned resection of non-communicating horn as described in literature but after assessing the anatomical proximity and good size of horn and small size of hemi-uterus we decided for unification of both. After injecting diluted inj. vasopressin, linear medial incision given in full thickness of myometrium with monopolar energy and opening the cavity with scissors. Both the walls sutured together first posteriorly and then anteriorly in double layer with no. 1 polyglactin 910 suture. Conclusion Good normal size, shape and contour of uterus appreciated after completion of procedure. After surgery patient had one normal menses without any pain suggest success of surgery.