Laparoscopic transabdominal cervico-isthmic cerclage: a minimally invasive approach |
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Authors: | Reid Geoffrey D Wills Hannah J Shukla Anshumala Hammill Peter |
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Institution: | Liverpool Hospital, Department of Women's and Child Health, Liverpool, Sydney, New South Wales, Australia. gdr@sgeg.info |
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Abstract: | BACKGROUND: While the traditional approach to management of cervical insufficiency has been the insertion of a transvaginal cerclage during pregnancy, a transabdominal cervico-isthmic suture is indicated in certain patients. This procedure is traditionally performed via laparotomy. Laparoscopic transabdominal cervico-isthmic cerclage (LTCC) placement, however, confers the benefit of the low morbidity associated with laparoscopy. AIMS: To describe the technique and outcomes of LTCC in three cases. METHODS: LTCC was performed using Mersilene tape at the level of the internal cervical os in the prepregnancy period in three patients: one with previous cervical amputation and two with previous failed cervical cerclage. Procedures were performed at a tertiary level endoscopic unit, Sydney, Australia. RESULTS: The laparoscopic approach enabled placement of a suture with no morbidity, and rapid patient recovery in these cases. CONCLUSIONS: Laparoscopic cervical cerclage proved technically feasible and safe for a surgeon trained in laparoscopic suturing methods. |
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Keywords: | cerclage cervical cervical incompetence laparoscopy |
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