Design: This was a routine laparoscopic surgery without intraoperative complications and with normal 4-week postoperative follow-up.

Setting: The patient was placed in low lithotomy position in Allen stirrups, taking care not to hyperflex or hyperextend the hips or the knees. Arms were tucked at her sides and her hands and elbows were padded and the chest was securely strapped with foam.

Patients or Participants: The patient was selected for this video case presentation based off her medical history significant for suspected Mullerian duct anomaly with suspected remnant and the desire for definitive surgical management.

Interventions: The procedure entailed a total laparoscopic hysterectomy with removal of two separate cervices and uteri, bilateral salpingectomy, intraperitoneal colpopexy for apical suspension and cystoscopy. Multiple different delineating devices were used during dissection to better appreciate surgical planes and allow for safer surgery.

Measurements and Main Results: The main result of this case was successful surgical removal of Mullerian duct remnants and alleviation of patient’s pelvic pain. During her postoperative follow-up, she denies further pelvic pain and was overall pleased with her decision for definitive surgical management.

Conclusion: Certain Mullerian anomalies present a difficult surgical scenario when patients desire surgical management of their clinical symptoms. In this case, safe laparoscopic surgery was performed with multiple surgical delineating devices when uterine manipulation was not feasible.