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Laparoscopic excision of a cesarean section scar

Epublication WebSurg.com, Dec 2013;13(12). URL: http://websurg.com/doi/vd01en4064

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  • 2013-12-06
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We present the case of a 33-year-old G1P1 patient who was adressed to our hospital for intermenstrual bleeding and pain. The patient had a C-section approximately 2 years earlier, and wanted to have another pregnancy. In the diagnostic work-up, ultrasonography showed a retroverted uterus with an image of a C-section scar niche, that had a 2mm thick remaining myometrium. A further hysteroscopic examination did not reveal bleeding lesions in the uterine cavity, but the cesarean scar was hyperemic and hemorrhagic, and had a non-absorbable suture. Taking into account the presence of non-absorbable suture material and the very thin remaining myometrium in a patient with a desire for another pregnancy, the decision was made to excise the pathologic scar, which was performed laparoscopically with a two-layered closure of the defect. At 3 months of follow-up, the patient was asymptomatic. Ultrasonographically, a niche image could be seen, with a 6mm thick myometrium.