Bicorporeal uterus: Laparoscopic metroplasty

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.