Design: Video footage illustrating the surgical steps.

Setting: A tertiary referral center.

Patients or Participants: The case involves a 40-year-old patient (G3P1021) with a history of secondary infertility who has been referred by a reproductive endocrinologist for surgical management of a cesarean scar niche. The patient's surgical history includes a previous Cesarean section, dilation and curettage for a Cesarean scar ectopic, and salpingectomy for a tubal ectopic pregnancy.

Interventions: A preoperative ultrasound revealed a Cesarean scar defect with a residual myometrial thickness of 1.9 mm and an incomplete septum measuring 1.5 cm. Hysteroscopy was performed to resect the incomplete septum using scissors and to identify the defect. While the hysteroscope tip was used to transilluminate through the uterine wall, the robotic Firefly technology was used to recognize the defect borders transabdominally. A robotic-assisted laparoscopic excision was then carried out, and the defect was closed in two layers using 0-barbed sutures.

Measurements and Main Results: N/A

Conclusion: Using the Firefly mode under hysteroscopic guidance during robotic excision of a cesarean scar niche allows for precise surgical mapping and may improve surgical outcomes.