Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Division of Colorectal Surgery, Department of Surgery, Alvin J. Siteman Cancer Center, and the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
Obstet Gynecol. 2017 Sep;130(3):561-564. doi: 10.1097/AOG.0000000000002196.
Gynecologic surgeries are performed through abdominal, vaginal, laparoscopic, or robot-assisted laparoscopic routes. However, if the pelvis is not accessible by one of these routes, there are no published reports to guide pelvic surgeons.
A 34-year-old conjoined twin status postseparation with uterine didelphys and absence of her left colon and sacrum underwent hemihysterectomy, at which time her müllerian anomaly was unknown. She re-presented with vaginal bleeding and pain eventually attributed to a retained uterine horn. Conservative management failed. Given dense adhesions, traditional approaches to hysterectomy were not successful. She underwent a transperineal hemisupracervical hysterectomy.
We propose a novel approach to the pelvis to guide surgeons when traditional approaches are not feasible. We also describe an instance of a retained uterine didelphys horn.
妇科手术可通过腹部、阴道、腹腔镜或机器人辅助腹腔镜途径进行。然而，如果骨盆无法通过这些途径进入，目前尚无发表的报告可以为骨盆外科医生提供指导。
一名 34 岁的联体双胞胎，在子宫双角和左侧结肠及骶骨缺失的情况下接受了半子宫切除术，当时她的苗勒管畸形并不为人知。她因阴道出血和疼痛再次就诊，最终被诊断为残留的子宫角。保守治疗失败。由于存在致密粘连，传统的子宫切除术方法未能成功。她接受了经会阴半经宫颈子宫切除术。
我们提出了一种新的骨盆入路方法，以指导传统方法不可行时的外科医生。我们还描述了一例残留的子宫双角。
