The effectiveness of transabdominal cerclage placement via laparoscopy or laparotomy: a systematic review and meta-analysis

Longitudinal change in cervical length following vaginal or abdominal cervical cerclage: a randomized comparison

“…Although there is currently insufficient evidence to recommend before or during pregnancy abdominal Original Research procedures, 25 our results indicate a potential mechanism of benefit for the TAC to be placed before conception, removing possible risks to the pregnancy and of rupturing the membranes and, therefore, increasing the surgeon's confidence to place the cerclage higher in the cervix. Although the numbers are small, and our study does not have adequate power, these findings are in line with the overall message of the article.…”

The minimally invasive approach to abdominal cerclage: indications, complications, and techniques for placement

“…A recent systematic review found high rates of fetal survival in TAC across all studies, generally greater than 90% [17 ▪▪ ]. Multiple large cohort studies have found neonatal survival rates to be as high as 98–100% [18,19,20 ▪ ].…”

“…An open approach to TAC placement via laparotomy (TAC-lap) was first described in the 1960 s and a laparoscopic approach (TAC-lsc) was first used in the late 1990 s. Laparoscopy is generally preferred to laparotomy given improved visualization and lower rates of hemorrhage, wound complications, postoperative pain, length of hospital stay, and subsequent adhesive disease. Multiple studies have confirmed that TAC-lsc is associated with a statistically significant decrease in blood loss, wound infections, and length of hospital stay when compared to TAC-lap [17 ▪▪ ,21,22].…”

“…Survival rates for TAC-lsc have increased over the last two decades likely due to improved surgeon technique [26]. Most recently, a comprehensive meta-analysis found similar survival rates and gestational ages at delivery between TAC-lsc and TAC-lap [17 ▪▪ ]. Given the benefits of laparoscopy, TAC-lsc is preferred to TAC-lap if an appropriately trained surgeon is available.…”

Updates on Laparoscopic Cervical Cerclage: Obstetric Outcomes and Surgical Techniques

“…Laparoscopic cervical cerclage is a surgical approach suggested to prevent premature labor in high-risk women with a history of failed transvaginal cerclage, trachelectomy, or absent vaginal cervix. Hulshoff et al [ 26 ] compared indirectly the laparotomy to the laparoscopic approach in transabdominal cerclage. They concluded that there is no superiority of one technique over the other one.…”