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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
B-Lynch suture for massive persistent postpartum hemorrhage following stepwise uterine devascularization
Loïc Sentilhes1, Alexis Gromez, Kaïs Razzouk
1Department of Obstetrics and Gynecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com
Acta Obstetricia Et Gynecologica Scandinavica
|October 18, 2008
Summary
The B-Lynch suture effectively controls severe postpartum hemorrhage (PPH) when vessel ligation fails, avoiding hysterectomy in most cases. This procedure shows low morbidity and preserves uterine function for future pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Surgical Innovation
- Maternal Health
Background:
- Severe postpartum hemorrhage (PPH) is a leading cause of maternal mortality.
- Vessel ligation is a common intervention for PPH, but may fail.
- Hysterectomy is often considered when conservative measures fail, impacting future fertility.
Purpose of the Study:
- To evaluate the effectiveness and safety of the B-Lynch suture for severe PPH after failed vessel ligation.
- To assess the impact of the B-Lynch suture on menstruation and uterine cavity.
- To determine if the B-Lynch suture can prevent hysterectomy.
Main Methods:
- A cohort study was conducted at a tertiary referral center.
- Fifteen women with persistent PPH despite vessel ligation underwent the B-Lynch suture.
- Data were collected via medical records and telephone interviews, focusing on hysterectomy, infection, hysteroscopy, and future menstruation.
Main Results:
- The B-Lynch suture controlled hemorrhage in 86.7% of cases, preventing immediate hysterectomy in 80%.
- The postpartum period was uneventful for 93.3% of women.
- Uterine preservation allowed for normal hysteroscopy findings in all evaluated cases, with no reported menopausal symptoms or menstrual changes.
Conclusions:
- The B-Lynch suture is an effective and safe procedure for managing severe PPH refractory to vessel ligation.
- It offers a viable alternative to hysterectomy, preserving uterine function and fertility.
- The technique demonstrates low morbidity and positive outcomes regarding menstruation and uterine health.
