Robotic Assisted Laparoscopic Resection of Anterior Adenomyoma

Abstract

Video Objective This video demonstrates a unique technique of anterior adenomyoma resection and repair of the defect laparoscopically. Setting Our patient is a 40 yo G 3P0020 with secondary infertility and had multiple failed euploid frozen embryo transfers. She was diagnosed to have an anterior adenomyoma and decision was taken to excise the adenomyoma to optimize the fertility outcome. Interventions We performed a robotic assisted laparoscopic anterior adenomyomectomy where we excised the adenomyoma leaving approximately 1 cm of myometrium to the endometrium and serosa and then close d the defect by the overlap flap technique. Conclusion We describe an unique technique for optimal adenomyoma resection and then the effective way to close the uterine defect. This technique is easily adaptable and reproducible. This repair technique achieves good myometrial thickness after closure that reduces the chance of uterine rupture and the addition of extra suture layer decreases the chance of hematoma formation.