Pendekatan Ganda (Laparoskopi dan Histeroskopi) untuk Memperbaiki Istmochele (Niche)

Objective: Reported a case demonstrate the double approach repair of niche treatment through the hysteroscopy and laparoscopy technique. Methods: Case report. We reported a case starting from the patient admission untill 3 months postoperative condition. Case: A thirty three years old woman came with abnormal uterine bleeding, already got medication and combine oral contraception pill, but the bleeding never stopped. We found a cavity (niche) filled by menstrual blood with thin lower uterine segment (just serous layer) from transvaginal ultrasound. We did hysteroscopy and laparoscopy approach. We illuminated the niche by hysteroscopy, then resected it by laparoscopy. Patient had a day hospital admission and no symptoms anymore after the procedure. Conclusions: Many treatment methods have been described for repair of niche with varies effectivities. Double approach (hysteroscopy and laparoscopy) technique was a minimal access, but optimal approach of niche resection with up to 100% effectivity.