Laparoscopic Strassman Metroplasty for Bicornuate Uterus with Successful Pregnancy

As our experience with laparoscopic suturing techniques and improved pregnancy outcome increase, the ability to do more complicated procedures to correct uterine anomalies increases as well. Laparoscopic Strassman metroplasties were performed in 5 patients with a bicornuate uterus who had a history of at least two 2nd trimester abortions. Using the triple puncture technique, after transverse fundal, a hysterectomy incision including the fundal cleft, unification of the uterus was performed with intracorporeal sutures in 2 layers. After 3 months of sequential hormone therapy, a hysterosalpingogram was repeated and second-look laparoscopy and hysteroscopy were done. The partial adhesion bands were released during the second-look laparoscopy and hysteroscopy. One patient became pregnant 6 months after the second-look operation. She received a tocolytic agent during the late 2nd and 3rd trimesters and delivered a 3300-g boy at 38 weeks of gestation. No defects or dehiscence along side of the incision line occurred.

Video by:
Dr. Hossein Asefjah
Ordibehesht Hospital, Shiraz, Iran