The surgical anatomy of extraperitoneal cesarean section

Bourgeois, George A.; Phaneuf, Louis E.

doi:10.1016/0002-9378(49)90424-x

Cited by 6 publications

(1 citation statement)

References 4 publications

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“…An additional indication was the diagnosis of Crohn's disease [6]. The extraperitoneal surgical approach, after undergoing different developmental phases following the work of Bourgeois et al [7] and later Ellis et al [8], has evolved to the modern version. The new version is the paravesical approach with preparation in the position of the medial or lateral umbilical ligament.…”

Section: Discussionmentioning

confidence: 99%

Extraperitoneal Cesarean Section after two Medial Laparotomies, Anus Prater, and Surgical Treatment of the Rectovaginal Fistula in a Patient with Crohn’s Disease: A Case Report

Bačić,

Hrgović,

Cerovac

et al. 2023

Z Geburtshilfe Neonatol

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The aim of this case report is to show the advantages of the extraperitoneal cesarean section (ECS) approach in a pregnant patient with multiple previous abdominal transperitoneal colon surgeries and Crohn’s disease. A pregnant nulliparous woman with Crohn’s disease was admitted for delivery. After delivery, a large rupture and lesion of the rectum was observed. Suturing of the vagina, rectum and sphincter was performed by an abdominal surgeon. Because of a very large and irregularly shaped rectum rupture, the patient underwent infraumbilical medial laparotomy and sigmoidostomy. After 18 months, the patient started to experience vaginal discharge and Y-shaped rectovaginal fistula was confirmed. Surgical reconstruction was performed. The patient’s second pregnancy began one year later. At 38 weeks of pregnancy, elective extraperitoneal cesarean section was performed. A healthy newborn was delivered. Follow-up showed full and fast recovery after the ECS. In cases of pregnant women who have had multiple colon surgeries, gynecology surgeons can choose to perform an ECS to avoid transperitoneal entrance into the abdomen. ECS avoids lysis of postoperative adhesions after repetitive gastrointestinal surgeries, the formation of new adhesions by lysis of the old adhesions, and most importantly, the possibility of colon or small intestine lesions during lysis of dense or firm adhesions.

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Section: Discussionmentioning

confidence: 99%