Clinical outcomes following interval laparoscopic transadominal cervico-isthmic cerclage placement: Case series

Abstract

The purpose of this report is to describe outcomes following laparoscopic transabdominal cervico-isthmic cerclage placement in cases of cervical incompetence not amenable to a conventional transvaginal procedure. We reviewed records of the first 11 patients at an academic teaching hospital who underwent laparoscopic transabdominal cerclage placement as an interval procedure, using a technique we previously first described. For all patients, the clinical course, including surgical complications and outcome of all subsequent pregnancies, is briefly described. One case was complicated by a small bowel injury secondary to concomitant extensive enterolysis. Otherwise there were no complications. Mean estimated blood loss was <40 ml. To date, 10 patients have conceived a total of 12 pregnancies following the procedure. Two pregnancies resulted in spontaneous losses at 8 weeks gestation, two in deliveries by Caesarean section at 34.5 weeks, and eight in deliveries by elective Caesarean section at 38 weeks or more. Each delivery resulted in the birth of a healthy infant. In conclusion, patients who require a transabdominal cerclage may undergo a laparoscopic interval procedure and achieve outcomes similar to those following placement via laparotomy during pregnancy.

Cerclage cervico-isthmique par voie abdominale : 13 cas au CHU de Rouen

“…Dix-neuf patientes ont accouché de 21 enfants vivants (dont deux paires de jumeaux) ; une seule perte foetale a eu lieu aprè s rupture des membranes à 19SA et cinq enfants sont né s pré maturé ment. Mingione et al [24] obtient 83 % de taux de naissances vivantes sur 11 femmes cerclé es. Dans notre sé rie, le taux de ré ussite du devenir obsté trical est similaire entre la voie coelioscopique et laparotomique.…”

“…Elle permet en particulier de diminuer le temps opé ratoire, la morbidité , la duré e d'hospitalisation, et d'é viter une laparotomie tout en conservant la même efficacité [11,[15][16][17][23][24][25].…”

Laparoscopic transabdominal isthmic cerclage in a case of cervical agenesis and a successful pregnancy with ICSI

“…Since then, these operations have been performed during pregnancy or before conception to prevent cervical insufficiency [4,5]. A less invasive approach is laparoscopic abdominal cerclage, which has the advantages of a laparoscopic procedure including no hospitalisation, less postoperative pain, and faster recovery [2].…”

Comment je fais… un cerclage isthmique par cœlioscopie

“…Cependant, la voie coelioscopique a récemment montré son efficacité et apparaît désormais comme une alternative fiable à la laparotomie [2].…”