Additional uses of a vaginal fornices delineator

Gibbs, Shelly; Widelock, T.; Elkattah, Rayan; DePasquale, Stephen

doi:10.1016/j.ajog.2015.06.029

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24] One additional study was identified through the search of references of the included studies. 25 The selected studies for inclusion were presented in details in Figure 1…”

Section: Resultsmentioning

confidence: 99%

“…The systematic search in PubMed and in Scopus databases revealed a total of 42 and 123 search results, respectively, among which 14 studies (four case series and 10 case reports) were identified as eligible for inclusion in this review, according to the inclusion criteria . One additional study was identified through the search of references of the included studies . The selected studies for inclusion were presented in details in Figure (flow diagram).…”

Section: Resultsmentioning

confidence: 99%

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Robotic assisted laparoscopic cerclage: A systematic review

Iavazzo

Minis

Gkegkes

2018

Robotics Computer Surgery

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Introduction The gold standard in the management of cervical incompetence is cerclage via vaginal approach. Minimally invasive techniques, such as robotic, have been also described. Materials and Methods A systematic search was performed in PubMed and Scopus, searching evidence on robotic assisted laparoscopic cerclage in both pregnant and non pregnant women. Results Sixty‐four patients were included in this study. Cervical insufficiency, failure of transvaginal cerclage, and short cervix were the most frequent indications for robotic assisted cerclage. Mean operative time was 107.3 minutes. Mean estimated blood loss was 62.8 mL. Four patients converted to laparotomy. No postoperative complications were reported. Pregnancy after robotic cerclage was reported in 59 patients with mean gestational age at delivery of 36.4 weeks. The majority of pregnant women who underwent robotic assisted cerclage gave birth to live neonates. Conclusion Till now, evidence does not show a clear advantage of robotic over laparoscopic approach, under the evaluation of the current literature. However, further comparative studies might be essential to clarify the possible role of da Vinci robot in this field; this might be quite difficult even in the near future based on the fact that only five cases per year are described in the current literature.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Robotic assisted laparoscopic cerclage: A systematic review

Iavazzo

Minis

Gkegkes

2018

Robotics Computer Surgery

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“…14 An early report described manual manipulation with an assistant's fingers, 9 and Gibbs et al 13 recently reported use of a vaginal fornices delineator, the Koh cup (Cooper Surgical, Inc, Trumbull, Connecticut, USA), to aid in manipulation and improve cervix visualization during a robot-assisted abdominal cerclage. 13 The Koh cup was first introduced in the mid-1990s by the gynecologic surgeon Charles Koh and has been used since that time to facilitate total laparoscopic hysterectomy. Gibbs et al used it as a manipulator during a cerclage procedure by assembling the tips of 2-ring forceps clamps along the base of the Koh cup, which encircles the cervix without disruption of the cervical canal.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Abdominal Cerclage During Pregnancy

Zeybek

Hill

Menderes

et al. 2016

JSLS

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Background and Objectives:Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We conducted this retrospective case study and literature review to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy.Methods:We conducted a case series and a systematic review that included patients who underwent robot-assisted abdominal cerclage during pregnancy from January 2010 through March 2016.Results:Six patients met the criteria for the case series. Median age was 34 years (range, 28–37) at the time of the procedure. In 5 cases, the indication for transabdominal cerclage was a failed vaginal cerclage in a previous pregnancy, whereas a scarred and shortened cervix caused by a previous dilatation and curettage–induced cervical laceration was the indication in the remaining case. Median operating time was 159.5 minutes (range, 124–204), and median estimated blood loss was 25 mL (range, 10–25). No surgeries were converted to laparotomies; all patients were discharged on postoperative day 1. The median gestational age at delivery was 37.5 weeks (range, 22–39). Five patients delivered between 36 and 39 weeks. No patients had chorioamnionitis or preterm premature rupture of membranes. One patient went into preterm labor at 22 weeks, and the cerclage was removed via minilaparotomy. Eight articles met the criteria for systematic review. Sixteen patients underwent robot-assisted abdominal cerclage during pregnancy. Median age was 31.5 years (range, 25–37). The major indication in most articles was previous failed transvaginal cerclage. The median gestational ages at time of procedure and delivery were 12 weeks (range, 10–15) and 37 weeks (range, 33–39), respectively.Conclusion:Robot-assisted abdominal cerclage is safe and effective during pregnancy.

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“…In brief, all patients are administered general anesthesia and placed in a dorsal lithotomy position. Facilitation of uterine manipulation is accomplished using a Koh vaginal fornices delineator as described previously [18]. Intra-abdominal access is achieved 8 cm superior to the umbilicus.…”

Section: Methodsmentioning

confidence: 99%