Laparoscopic cervico-isthmic cerclage: surgical technique and obstetric outcomes

Whittle, Wendy; Singh, Sukhbir S.; Allen, Lisa; Glaude, L.; Thomas, Jasmin; Windrim, Rory; Leyland, Nicholas

doi:10.1016/j.ajog.2009.07.018

Cited by 76 publications

(74 citation statements)

References 29 publications

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“…This is in agreement with a previous study in 2009 [6], where the fetal salvage rate was 89%. They used criteria for a presumptive diagnosis of cervical insufficiency including failed transvaginal cerclage in 58% of cases.…”

Section: Discussionsupporting

confidence: 94%

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Abdominal cerclage after failed transvaginal cervical cerclage

et al. 2011

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This study aimed to evaluate the efficacy of abdominal cerclage by laparotomy and by laparoscopy among women who had failed transvaginal cerclage. We evaluated all women with cervical insufficiency that underwent abdominal cerclage between the years 2000 and 2010. Of a total of 20 patients, 12 patients underwent abdominal cerclage by laparoscopy and 8 others by laparotomy. The procedure was done in the pregnant state in four patients in the laparoscopy group and in all patients in the laparotomy group. There was no significant difference in the operative time between the laparoscopy and the laparotomy group. The median duration of hospitalization in the laparoscopy group was 6 h and in the laparotomy group was 96 h. Of 18 pregnancies, 16 resulted in a live birth (88.9%). Abdominal cerclage in women who have failed a transvaginal cervical cerclage is associated with a high live birth rate.

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Section: Discussionsupporting

confidence: 94%

“…They used criteria for a presumptive diagnosis of cervical insufficiency including failed transvaginal cerclage in 58% of cases. Conversion to laparotomy was needed in 10% of cases due to bleeding from the uterine vessels and impaired visibility [6].…”

Section: Discussionmentioning

confidence: 99%

Abdominal cerclage after failed transvaginal cervical cerclage

et al. 2011

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“…The results are shown in Table 1. [15][16][17][18][19][20][21][22][23][24][25] The number of patients that were treated each year ranges from 1 to 101, with majority of the cases done before pregnancy, and, in all, reveals very minimal intraoperative complications which were seen in only three cases -2009, 2013, and 2014, with intraoperative complications of 10.7, 4.5, and 1.6% respectively; others did not record any form of complications. There were no severe complications like infection, severe hemorrhage, and injury of peripheral organs.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Ayegbusi¹

2017

WJOLS

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Cervical incompetence/insufficiency occurs in 0.1 to 1% of all pregnancies, and, traditionally, management involves transvaginal cervical cerclage. In some situations, however, such as in extremely short cervix following cone biopsy, congenital absent cervix, and in cases where transvaginal cerclage fails or is technically impossible, transabdominal approach via laparotomy is usually done. Recent data suggest that these methods should be reviewed in light of the advantages seen in the developments of minimal access surgical techniques.This article, therefore, compares both approaches (conventional and laparoscopy) and, in particular, discusses the use of laparoscopy in the management of cervical incompetence/ insufficiency both in pregnant and nonpregnant uterus.

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“…It compares favourably with the laparotomy approach to cerclage [12][13][14][15] but with the full benefits of a brief laparoscopic operation. The cervicoisthmic level, being the site of placement for the LTAC cannot be easily reached through a vaginal approach without major dissection or clear perception of anatomy, hence the laparoscopic approach offers greater advantage with reduced hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Preconception Laparoscopic Cervical Cerclage: The Preferred Technique for Cervical Incompetence?

Jape¹,

Rowlands²

2016

JFIV Reprod Med Genet

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Objective: To explore the ease and effectiveness of placing a cervical suture preconception using a laparoscopic technique.Design: A case study with systematic literature review.Setting: PIVET Medical Centre, a private facility providing comprehensive services over 35 years in gynaecology, andrology and reproductive endocrinology for infertility and recurrent pregnancy loss.Patients: Case report of a 35 year old woman with recurrent mid-trimester pregnancy losses and well-define cervical incompetence.Intervention: Preconception placement of cervical suture by laparoscopic trans-abdominal cerclage (LTAC) as a day case. Main outcome measure: Details of ensuing pregnancy.Results: Conception without delay and normal pregnancy with delivery by elective caesarean section near term of healthy 2645 g female infant. Conclusion:We are impressed with the ease of the LTAC technique which appears likely to have fewer complications than traditional vaginal techniques, as well as speedier recovery compared to a laparotomy approach.

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Laparoscopic cervico-isthmic cerclage: surgical technique and obstetric outcomes

Cited by 76 publications

References 29 publications

Abdominal cerclage after failed transvaginal cervical cerclage

Abdominal cerclage after failed transvaginal cervical cerclage

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Preconception Laparoscopic Cervical Cerclage: The Preferred Technique for Cervical Incompetence?

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