TITLE:
Laparoscopic Transabdominal Cerclage
AUTHORS:
Marilien Gebruers, Yves Jacquemyn, Jérôme Cornette
KEYWORDS:
Cerclage; Cervical Insufficiency; Laparoscopy
JOURNAL NAME:
Surgical Science,
Vol.4 No.4,
April
16,
2013
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.