Total laparoscopic hysterectomy for endometrial carcinoma coexisting with uterus didelphys and sigmoidovesical interposition: A case report

hysterectomy Uterus didelphysTo the Editor, A 36-year-old G0P0 woman with class III obesity (BMI 42.9 kg/ m 2 ) and type 2 diabetes mellitus presented with a 1-month history of irregular vaginal bleeding.She had no prior sexual activity or family history of malignancy.Pelvic examination revealed a vaginal septum and duplicated cervices; however, massive abdominal adiposity precluded a comprehensive pelvic assessment.Contrast-enhanced pelvic MRI confirmed complete uterus didelphys, demonstrating restricted diffusion in the left uterine horn suggestive of malignancy (Fig. 1A-C).Hysteroscopy with dilation and curettage revealed endometrioid carcinoma in the left uterine horn and atypical endometrial hyperplasia in the right uterine horn.After detailed counseling, the patient declined fertility-sparing therapy and underwent total laparoscopic hysterectomy, bilateral salpingectomy, ovarian transposition, and sentinel lymph node mapping in November 2023.Intraoperative exploration revealed