Endoscopic transabdominal cervical cerclage

Abstract

Objective To describe a case of endoscopic transabdominal cervical cerclage. Setting St Mary’s Hospital, Paddington, London, UK. Subject A 33‐year‐old lady with clinical cervical incompetence. Intervention Cervical cerclage was performed with zero gauge coated polyester at the level of the internal os. Results The duration of the operation was 50 min and was performed uneventfully. Prior to surgery the cervix admitted the largest dilator available (14 mm) without resistance. After the operation, the internal os did not admit a dilator of 9.5‐mm diameter. The patient was discharged 18 hours after completion of the procedure. Conclusion In this instance, laparoscopic cervical cerclage proved technically easy for a surgeon trained in laparoscopic suturing methods and resulted in discharge from hospital in the morning following an afternoon procedure.

Laparoscopic transabdominal cervico‐isthmic cerclage: A minimally invasive approach

“…Patients with a history suggestive of cervical incompetence who are unsuitable for transvaginal cerclage, and those with previously failed transvaginal cerclage, should be given the option of laparoscopic interval cerclage. There are a number of case reports and case series published in the literature describing LTCC in well‐selected patients attesting to its safety and effectiveness 8–11 . A study of 19 preconception transabdominal cervico‐isthmic cerclages demonstrated a postoperative fetal survival rate of 100% for pregnancies that reached more than 12 weeks gestation, compared with a preoperative fetal survival rate of 12% 12 …”