Design: Case Report

Setting: OR setting. Patient positioned in the dorsal lithotomy position. General anesthesia.

Patients or Participants: 34 year-old nulligravid woman with imaging confirmed large, thick, incomplete uterine septum.

Interventions: Hysteroscopic resection and transection of the uterine septum in the coronal plane

Measurements and Main Results: N/a due to the case design of a case report

Conclusion: The surgical approach for metroplasty is best individualized to the patient's medical & surgical history, imaging findings, and intraoperative findings. This inherent dynamic and tailored nature of the procedure, combined with the use of small and delicate surgical instruments, has the propensity to manifest scenarios in which troubleshooting intraoperatively may be required, all while maintaining surgical efficiency in order to avoid the threat of premature termination of the procedure due to reaching the maximum hysteroscopic fluid deficit. Additionally, we must consider preserving the new uterine cavity with both mechanical and pharmacologic methods.