Robotic Resection of a Non-Communicating Right Uterine Horn

Study Objective We present an uncomplicated robotic resection of a uterine horn in a teenage patient to highlight a minimally invasive approach, emphasize the importance of preoperative imaging, discuss potential areas for intraoperative complications, and address the possibility of trial of labor. Design N/A Setting Academic Medical Center - The patient was a 14-year-old nulligravida who presented to the Emergency Room for cyclic, right sided abdominal four months after menarche. The patient was found to have a unicornuate uterus with a functional, non-communicating rudimentary right uterine horn as demonstrated by an MRI obtained with and without contrast. The MRI included examination of the renal system, which was normal in this patient. Patients or Participants N/A Interventions Robotic resection of a non-communicating uterine horn with right salpingectomy. Measurements and Main Results N/A Conclusion Uterine malformations do not always occur in isolation. Given the high incidence of renal tract malformations associated with Mullerian duct anomalies, specifically unicornuate uterus, it is imperative that you obtain preoperative imaging to confirm a normal or abnormal renal system. As far as we are aware, there is not a standardized approach to removal of uterine horns. A minimally invasive approach, whether laparoscopic or robotic, should be the standard of care. Although this case was without complications, due to the unpredictability of these anomalies, a skilled surgeon should be involved with the case, especially one who is prepared to deal with a variety of complications. Additionally, we propose that patients with a history of a non-communicating uterine horn resection without entry in the uterine cavity be given the option for a trial of labor, with caution, similar to myomectomies.