The Use of Foley Catheters in Hysteroscopy Combined With Laparoscopy for the Treatment of Post-Cesarean Section Uterine Diverticulum

Study Objective

To evaluate the effectiveness and utility of a Foley catheter as an innovative support tool in managing a large and rare cesarean scar diverticulum during laparoscopic repair, aiming to address post-cesarean section complications related to prolonged menstruation.

Design

This video demonstrates a combined laparoscopic and hysteroscopic surgical technique, with a special emphasis on using the Foley catheter as a support tool to enhance the surgical field and precision. Once the diverticulum is located via hysteroscopy, the Foley catheter is deployed to stabilize and delineate the diverticulum, followed by precise dissection and repair of the diverticulum walls under laparoscopy.

Setting

The procedure was conducted in a high-tech operating room at a university hospital.

Patients or Participants

The patient is a 35-year-old woman with a history of one cesarean section who had been experiencing prolonged menstrual bleeding for one year. Diagnostic imaging showed a large and rare cystic structure measuring 30mm x 30mm on the right side of the uterus.

Interventions

A Foley catheter was inserted into the diverticulum under hysteroscopic guidance to act as a mechanical scaffold, which enhanced visualization and stability of the diverticulum during laparoscopic surgery. This was followed by the precise dissection and repair of the diverticulum walls, improving the safety and effectiveness of the surgery.

Measurements and Main Results

Postoperative assessments indicated a significant reduction in menstrual bleeding and resolution of the diverticulum issues. The use of the Foley catheter provided essential structural support, enabling more effective manipulation and treatment of the scar tissue.

Conclusion

This case highlights the pivotal role of the Foley catheter in managing a large and rare cesarean scar diverticulum. It introduces a new surgical technique that could offer an effective surgical option for managing post-cesarean section complications, providing a replicable and effective method for managing similar cases.