Laparoscopic metroplasty in bicornuate and didelphic uteri

Objective: To determine the feasibility of laparoscopic metroplasty, in the treatment of bicornuate and didelphic uteri. Design: Case report. Setting: University and private hospitals. Patient(s): Four women with a diagnosis of double uterine cavity (two bicornuate and two didelphic uteri) with a history of two recurrent spontaneous abortions at less than 5 months of pregnancy. Intervention(S): Laparoscopic metroplasty with diapostic hysteroscopy was performed for the unification of the uterus. Second-look laparoscopy and hysteroscopy was performed about 3 months later. Main Outcome Measure(S): Evaluation of the uterine compliance to high intrauterine pressure and presence of adhesions in the pelvic and uterine cavities. Result(s): In all four patients, laparoscopic metroplasty resulted in a unified uterus with a good cavity and tolerance to high intrauterine pressure. Minimal pelvic adhesions were noted in the two patients at the second surgery. Conclusion(S): This new technique of laparoscopic metroplasty is an acceptable alternative for abdominal metroplasty, with minimal adhesion formation. (Fertil Steril (R) 2009;92:352-5. (C) 2009 by American Society for Reproductive Medicine.)