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Updated: Jun 7, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri

Published on: September 12, 2025

Transabdominal cervical cerclage.

Mark P Umstad¹, Michael A Quinn, Alex Ades

¹Department of Perinatal Medicine, Royal Women's Hospital, Parkville, Victoria, Australia. umstad@bigpond.net.au

The Australian & New Zealand Journal of Obstetrics & Gynaecology

|November 3, 2010

Summary

This summary is machine-generated.

Transabdominal cervical cerclage via laparotomy is a safe and effective procedure for women unable to have a vaginal suture. This study establishes a baseline for comparing future laparoscopic approaches.

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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri

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Published on: May 10, 2024

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Transabdominal cervical cerclage (TACC) has been performed via laparotomy for over 40 years.
A newer laparoscopic approach for TACC offers potential for reduced patient morbidity.

Purpose of the Study:

To review one surgeon's experience with transabdominal cervical cerclage via laparotomy.
To establish a baseline for comparing outcomes with the laparoscopic TACC approach.

Main Methods:

Transabdominal cervical cerclage was performed using Mersilene tape.
Pregnancy outcomes before and after TACC insertion were compared.

Main Results:

Before TACC, 18 of 58 pregnancies resulted in first-trimester loss, and 28 of 36 pregnancies between 13-26 weeks gestation were lost.
After TACC, no first-trimester losses occurred; 22 of 23 pregnancies resulted in delivery at a mean of 36.2 weeks gestation.
Maternal morbidity was low (one wound infection), and neonatal respiratory distress resolved in all affected infants.

Conclusions:

Transabdominal cervical cerclage via laparotomy is a safe and successful treatment for women requiring cervical cerclage who cannot undergo a vaginal procedure.
This study provides a crucial baseline for evaluating the emerging laparoscopic TACC technique.