Laparoscopic Repair of Subacute Uterine Inversion by Haultain's Technique: A Case Report

Abstract

Study Objective To show that Laparoscopic approach is beneficial for surgical repair of uterine inversion cases. Design A case report. Setting Pandit Hospital and Laparoscopy centre, Ahmednagar, India. Patients or Participants A 26 year female presented with subacute uterine inversion in January 2020. Interventions Laparoscopic Haultain's repair for subacute uterine inversion. Measurements and Main Results Although in modern era, endoscopy has replaced abdominal or vaginal surgeries, there is hardly any case report of laparoscopic management of uterine inversion. Here, we report a case of successful management of subacute uterine inversion by Laparoscopic approach by Haultain's technique, which is done for the first time as per our knowledge and no such case of laparoscopic repair is been mentioned in the literature. A 26 year old P2L2, presented on seventh day postpartum with complaints of continuos bleeding per vaginum and fever. Patient was febrile with temperature of 99 F with tachycardia. On per abdominal examination, uterus was much below the umbilicus and indentation was felt at the level of fundus. On per speculum examination, endometrium was seen protruding outside, so inversion of uterus was suspected which was confirmed on ultrasonography of pelvis. Before going for the Laparoscopy, manual reposition of uterus was tried under general anaesthesia but was not successful. During Laparoscopic Haultan's repair, posterior wall of uterus was incised at the rim. By continuous upward traction on bilateral round ligament, inversion was corrected. Uterine incision was closed in double layer. Patient was asymptomatic on discharge and on fallow up examination after seven days and one month. Conclusion Uterine inversion cases can be managed laparoscopically without any harmful effects and with added benefits of laproscopic route as for any other procedure. To show that Laparoscopic approach is beneficial for surgical repair of uterine inversion cases. A case report. Pandit Hospital and Laparoscopy centre, Ahmednagar, India. A 26 year female presented with subacute uterine inversion in January 2020. Laparoscopic Haultain's repair for subacute uterine inversion. Although in modern era, endoscopy has replaced abdominal or vaginal surgeries, there is hardly any case report of laparoscopic management of uterine inversion. Here, we report a case of successful management of subacute uterine inversion by Laparoscopic approach by Haultain's technique, which is done for the first time as per our knowledge and no such case of laparoscopic repair is been mentioned in the literature. A 26 year old P2L2, presented on seventh day postpartum with complaints of continuos bleeding per vaginum and fever. Patient was febrile with temperature of 99 F with tachycardia. On per abdominal examination, uterus was much below the umbilicus and indentation was felt at the level of fundus. On per speculum examination, endometrium was seen protruding outside, so inversion of uterus was suspected which was confirmed on ultrasonography of pelvis. Before going for the Laparoscopy, manual reposition of uterus was tried under general anaesthesia but was not successful. During Laparoscopic Haultan's repair, posterior wall of uterus was incised at the rim. By continuous upward traction on bilateral round ligament, inversion was corrected. Uterine incision was closed in double layer. Patient was asymptomatic on discharge and on fallow up examination after seven days and one month. Uterine inversion cases can be managed laparoscopically without any harmful effects and with added benefits of laproscopic route as for any other procedure.