Laparoscopic Removal of Uterine Remnant with Ureterolysis

Laparoscopic Removal of Uterine Remnant with Ureterolysis

We performed a difficult laparoscopic surgery on a woman who had undergone a partial removal of the uterus during a prior laparotomy. The uterine remnant had led to development of severe pelvic endometrioisis. In addition, due to extraperitoneal injury to the urinary bladder during the laparotomy, she had developed bilateral hydronephrosis and renal failure due to retroperitoneal fibrosis. Via laparoscopy, we released the pelvic adhesions, performed a hysterectomy with bilateral removal of the ovaries and Fallopian tubes, and released both the ureters from the retroperitoneal fibrosis in a grueling four hour surgery. A bladder tear was sutured with interposition of an omental flap.