Laparoscopic Transabdominal Cerclage

Marilien Gebruers, Yves Jacquemyn, Jérôme Cornette

Department of Obstetrics and Gynecology, University Hospital Antwerp (UZA), Antwerp, Belgium.
Department of Obstetrics, Erasmus Medical Centre, Rotterdam, The Netherlands.

DOI: 10.4236/ss.2013.44044                

Abstract

Cervical insufficiency is seen in 0.1% - 1% of all pregnancies and classical treatment involves vaginal cerclage. In some conditions, such as an extremely short, deformed or absent cervix, surgery needs to be done by transabdominal approach. We use a simplified technique for laparoscopic transabdominal cerclage compared to the technique described in previous studies. Furthermore, we give a review on the literature published on this subject. We have a case series of 12 patients operated in a non-pregnant state with previously failed vaginal cerclage (n = 4) or in which a vaginal approach appeared to be impossible due to a history of cervical surgery (n = 8). Minor complication of vaginal erosion of the cerclage tape was described in 2 cases. Comparable studies of transabdominal cerclage via laparotomy or laparoscopy could not show any difference in obstetric outcome. Several studies mentioned the advantages of the laparoscopic approach (short hospitalisation, fast recovery, high placement of the suture,) and no complications were described. Transabdominal cerclage performed by laparoscopy seems to be a feasible technique in cases transvaginal cerclage fails or is technically impossible.

Keywords

Cerclage; Cervical Insufficiency; Laparoscopy

Conflicts of Interest

The authors declare no conflicts of interest.

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