Robot-assisted transabdominal cerclage for the prevention of preterm birth: A multicenter experience

Tyan, Paul; Mourad, J.; Wright, Brian; Winter, M.L.; Garza, Devon; Smith, Richard F.; Brink, Janel; Wei, Chapman; Moawad, Gaby

doi:10.1016/j.ejogrb.2018.11.013

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…This clearly demonstrates the benefits of robotic surgery in cases complicated by high BMI. 9 For patients such as Mrs. L K with high BMI, robotic surgery can function as a means to undertake complex surgery while preserving an MIS approach reducing intra and post-operative complications.…”

Section: Discussionmentioning

confidence: 99%

A successful full term delivery in a case of robotic assisted insertion of transabdominal cerclage in an obese woman with multiple uterine fibroids

Tan

Durai

Devendra

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Cervical incompetence is not an uncommon presentation in an obstetric emergency unit. Some of these patients will be managed with a cervical cerclage. While the management of patients presenting with first time cervical incompetence is relatively established, the management of patient with repeated cervical incompetence might require an abdominal cerclage. Abdominal cerclages can be inserted traditionally via laparotomy or via a minimally invasive approach (MIS). We present a case of an obese patient presenting with 3 previous second trimester miscarriages despite 2 cervical cerclage complicated by multiple uterine fibroids who underwent a robotic assisted insertion of transabdominal cerclage (RTAC) pre-pregnancy. She subsequently conceived spontaneously and carried the pregnancy to term and delivered a healthy baby via caesarean section. There have been multiple published studies showing that an MIS approach for abdominal cerclage insertion is safe and viable. Robotic assisted procedures allow for better visualisation and manipulation of tissue especially in patients anticipating a complex procedure. For our patient we feel that a robotic assisted procedure would be more beneficial given her profile and the complexity of her case.

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Section: Discussionmentioning

confidence: 99%

A successful full term delivery in a case of robotic assisted insertion of transabdominal cerclage in an obese woman with multiple uterine fibroids

Tan

Durai

Devendra

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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“…First-trimester losses are typically excluded from the denominator as they are unlikely the result of cervical insufficiency. According to the literature, neonatal survival rates after a laparoscopic or open abdominal cerclage range from 71% to 100% (2,13,(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Abdominal Cerclage Outcomesmentioning

confidence: 99%

“…Laparoscopic abdominal cerclage can also be placed with robotic assistance, depending on the surgeon's preference. Several case reports and series have used the da Vinci robotic system (Intuitive Surgical) with good outcomes (21,(41)(42)(43)(44)(45)(46). Robotic techniques to reduce bleeding have been described, including complete skeletonization of the uterine vessels to allow needleless introduction of the suture (47).…”

Section: Surgical Techniquementioning

confidence: 99%

Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency

Clark

Einarsson

2020

Fertility and Sterility

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Laparoscopic abdominal cerclage is emerging as the preferred treatment option for patients with refractory cervical insufficiency. Laparoscopic abdominal cerclage reduces second-trimester loss and preterm birth with success rates similar to open abdominal cerclage. Increasing evidence also suggests improved neonatal survival rates with abdominal cerclage compared with repeat vaginal cerclage in patients who delivered prematurely despite a vaginal cerclage. The option to perform a highly effective treatment using minimally invasive techniques suggests laparoscopic abdominal cerclage will become the standard of care for refractory cervical insufficiency. This review examines the literature with regard to the indications and outcomes of abdominal cerclage, highlighting the laparoscopic technique. (Fertil Steril Ò 2020;113:717-22. Ó2020 by American Society for Reproductive Medicine.

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“…This is a burden for patients who wish to undergo the procedure. To prevent multiple laparotomies, a laparoscopic procedure or a robot-assisted procedure might be an alternative option for patients (10,11). Laparoscopic procedures seem to be more complicated and take more time, but will not be a big problem for skilled laparoscopic surgeons, and we believe the laparoscopic approach might be the main one for TAC in the near future.…”

mentioning

confidence: 98%

Transabdominal cerclage (TAC) as a new tool for the treatment of cervical incompetence (CI)

et al. 2020

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Robot-assisted transabdominal cerclage for the prevention of preterm birth: A multicenter experience

Cited by 11 publications

References 17 publications

A successful full term delivery in a case of robotic assisted insertion of transabdominal cerclage in an obese woman with multiple uterine fibroids

A successful full term delivery in a case of robotic assisted insertion of transabdominal cerclage in an obese woman with multiple uterine fibroids

Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency

Transabdominal cerclage (TAC) as a new tool for the treatment of cervical incompetence (CI)

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