V1713 PEDIATRIC ROBOT-ASSISTED LAPAROSCOPIC RESECTION OF A FUNCTIONAL NON-COMMUNICATING UTERINE HORN

Abstract

You have accessJournal of UrologyPediatrics & Reconstruction1 Apr 2011V1713 PEDIATRIC ROBOT-ASSISTED LAPAROSCOPIC RESECTION OF A FUNCTIONAL NON-COMMUNICATING UTERINE HORN Manoj Rao, Andrew Marks, and Bruce Lindgren Manoj RaoManoj Rao Chicago, IL More articles by this author , Andrew MarksAndrew Marks Chicago, IL More articles by this author , and Bruce LindgrenBruce Lindgren Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2038AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present robot assisted laparoscopic resection of a non-communicating functional uterine horn in a pediatric patient. To our knowledge, this is the first reported robot assisted procedure for this indication in a pediatric patient. METHODS A 13-year-old female presented from an outside hospital with left abdominal pain. She was found to have a cystic pelvic mass and underwent open resection via a pfannensteil incision with pathology showing hematosalpinx and encased ovary. Post operatively, she returned with recurrent left abdominal pains and left leg numbness and tingling. MRI showed a right unicornuate uterus and a non-communicating, functional left uterine horn with hematometros as well as left sided renal agenesis. She was transferred to our facility for further care. A robotic resection of the non communicating uterine horn was performed. RESULTS After positioning in dorsal lithotomy, we performed examination under anesthesia, cystoscopy and vaginoscopy, identifying a single right-sided cervix and a mass effect on the left pushing on the bladder. We proceeded with robot assisted laparoscopic resection. We used an 8.5 mm camera port 2 cm superior to the umbilicus. We identified the left uterine horn and the normal contralateral uterine horn, ovary and fallopian tube. Two 8 mm robotic ports were placed in the right and left lower quadrants and a 10 mm assistant port was placed through the right lateral aspect of her prior pfannensteil incision. The distended uterine horn was punctured and 60 ml of hemolyzed blood aspirated for decompression. The sigmoid colon was aherent to the lateral aspect of the uterine horn due to previous salpingo-oophorectomy, and was dissected away. The vascular pedicle to the left uterine horn was ligated with a harmonic scalpel. The fibrotic attachment of the uterine horn to the vagina was identified and divided, with guidance from an assistant's finger to delineate the lateral wall of the vagina and the rectum. The specimen was placed into an endocatch bag inserted via the assistant port, and the incision extended along her prior Pfanensteil incision specimen retrieval. Estimated blood loss was 100 ml. She was discharged home post operative day three. On follow up she had no abdominal pain and lower extremity numbness had resolved. CONCLUSIONS Robot-assisted laparoscopic resection of a functional uterine horn can be performed successfully, safely, and with good outcome. This technique offers a minimally invasive approach to a complicated internal genital anomaly and is another robot assisted procedure for the urologist's armamentarium. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e688 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Manoj Rao Chicago, IL More articles by this author Andrew Marks Chicago, IL More articles by this author Bruce Lindgren Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...