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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
A novel method for laparoscopic abdominal cerclage utilizing minimally invasive hydrodissection: a case report
Ramzi Aboujaoude1, Paul Maloof, Manuel Alvarez
1Department of Obstetrics, Gynecology and Women's Health, Hackensack University Medical Center, Hackensack, New Jersey, USA. ramziajaoude@hotmail.com
The Journal of Reproductive Medicine
|June 23, 2007
Summary
Laparoscopic abdominal cerclage offers a safe surgical option for women with cervical incompetence and insufficient cervical tissue, minimizing risks to the gravid uterus during pregnancy. This minimally invasive technique aids in preventing second-trimester pregnancy losses.
Area of Science:
- Reproductive Medicine
- Minimally Invasive Surgery
- Maternal-Fetal Medicine
Background:
- Cervical incompetence is a significant cause of second-trimester pregnancy loss.
- Transvaginal cerclage is effective, but transabdominal cerclage is necessary for patients lacking cervical tissue.
- Traditional transabdominal cerclage via laparotomy poses risks to the maternal-fetal unit.
Observation:
- A 22-year-old pregnant patient at 13 weeks' gestation with a history of cervical incompetence and absent cervical tissue underwent abdominal cerclage.
- Laparoscopic techniques were employed for cerclage placement.
- Hydrodissection was utilized to minimize bleeding and manipulation around the uterus.
Findings:
- Laparoscopic abdominal cerclage can be successfully performed in patients with cervical incompetence.
- The procedure demonstrated minimal manipulation and bleeding.
- The technique appears safe for the gravid uterus.
Implications:
- Laparoscopic abdominal cerclage provides a safer alternative to open laparotomy for cerclage placement in select patients.
- This approach may reduce maternal-fetal morbidity associated with abdominal cerclage.
- Further research can explore the long-term outcomes and broader application of this technique.
