Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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New approach for T-shaped uterus: Metroplasty with resection of lateral fibromuscular tissue using a 15 Fr miniresectoscope. A step-by-step technique

U. Catena 1, R. Campo 2, G. Bolomini 1, M.C. Moruzzi 1, V. Verdecchia 1, F. Nardelli 1, I. Romito 1, F. C amolo 1, V. La Manna 1, M.M. Ianieri 1, G. Scambia 1,3, A.C. Testa 1,3

1 Department of Women’s and Children’s Health, Fondazione Policlinico Universitario “A. Gemelli”- IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy;
2 Department of Obstetrics and Gynecology, ZOL Hospitals, Genk, Belgium;
3 Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy.

Keywords:

Hysteroscopy, T-shaped uterus, metroplasty, mini-resectoscope, dysmorphic uterus, three-dimensional ultrasound


Published online: Mar 31 2021

https://doi.org/10.52054/FVVO.13.1.003

Abstract

T-shaped uterus is a congenital uterine malformation (CUM), only recently defined by the ESGE ESHRE classification as Class U1a. The uterus is characterised by a narrow uterine cavity due to thickened lateral walls with a correlation 2/3 uterine corpus and 1/3 cervix. Although the significance of this dysmorphic malformation on reproductive performance has been questioned, recent studies reported significant improvement of life birth rates after surgical correction in patients with failed in-vitro fertilisation (IVF) or recurrent miscarriage. The classical surgical technique to treat a T-shaped uterus is by performing a sidewall incision with the micro scissor or bipolar needle, resulting in a triangular cavity.

In this video article, we describe a new surgical technique with a step-by-step method combining three-dimensional ultrasound (3D-US) and hysteroscopic metroplasty in an office setting, using a 15 Fr office resectoscope (Karl Storz, Tuttlingen, Germany), to treat a T-shaped uterus by resecting the lateral fibromuscular tissue of the uterine walls. No complications occurred and the postoperative hysteroscopy showed a triangular and symmetrical uterine cavity without any adhesions.

Video available at: https://vimeo.com/465700803/4ba8de0b78