Didelphys Uterus: Total Robotic Hysterectomy

Juan Roberto Gonzalez Santamaria, MD, FACS

Product Details
Product ID: ACS-6169
Year Produced: 2020
Length: 11 min.


Mullerian duct anomalies are congenital defects of the female reproductive system, taking place between the 6 y 22 weeks in utero, they are the result of a failure in the development, fusion, canalization or reabsorption of the ducts. The incidence of these anomalies is between 0.5% to 5.0% of the general population, being didelphys uterus the most common in almost 35%, being followed by bicorne uterus in 25% and arcuate uterus in 20%.Abdominal hysterectomy is the preferred option in treatment for abnormal uterine bleeding in association with development anomalies.Although there are several reports of this disease, there are very few reports with a minimally invasive approach.The robotic approach emerged as a modification to the laparoscopic technique, offering advantages like better ergonomics, wider range of movements and articulated instruments that makes easier complex tasks such as dissection and suture in reduced spaces.This case attempts to provide our experience with the robotic approach on a patient with didelphys uterus. We present the case of a 55-year-old female, with chronic abdominal pain, and abnormal uterine bleeding due to medium and small fibroids. We performed a complete preoperative protocol with pelvic USG, abdominal TC, blood tests with tumor markers, and anesthesia and cardiovascular assessment, with no contraindication for surgery. The surgery was performed on Da Vinci Si platform, with total surgery time of 2 hrs and minimum blood loss.The patient evolves properly and was discharged in the first 24 hrs of the postop to continue ambulatory surveillance.