Abstract: Objective: To investigate the effect of modified laparoscopic combined hysteroscopic surgery on cesarean section incision diverticulum repair. Methods: From October 2017 to October 2018, 21 patients with re-fertility requirements who were confirm the diagnosis of uterine incision diverticulum in the cesarean section, and the muscle layer thickness ≤2 mm at the bottom of the diverticulum using ultrasound combined with hysteroscopy received modified laparoscopic combined with hysteroscopic surgery in department of gynecological minimally invasive center，Beijing Obstetrics and Gynecology Hospital，Capital Medical University. Follow-up of menstrual recovery and improvement of diverticulum muscle thickness was recorded. Results: All patients underwent surgery without complications. There was no conversion to open surgery or blood transfusion. 21 patients were followed up for 6 to 14 months after menstrual rehydration. The menstrual period was shortened significantly after operation [(6.0±1.2) d vs. (11.2±3.5) d，t=10.79，P=0.00] . The thickness of the lower uterine segment measured by transvaginal ultrasound was increased significantly after operation [(3.25±0.95) mm vs. (1.59±0.30) mm, t=8.00, P=0.00]. Conclusions: The modified laparoscopic combined hysteroscopic operation can accurately locate the diverticulum and fully remove the scar through the light-transmitting positioning, the suture incision is good and the anatomy of the lower uterus is restored. It is safe and effective, and worthy of clinical application.

Key words: Cesarean section, Uterus, Diverticulum, Hysteroscopy, Laparoscopy