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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
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Laparoscopic abdominal cerclage after radical vaginal trachelectomy
Clinical and Experimental Obstetrics & Gynecology
|June 28, 2018
Summary
Radical vaginal trachelectomy (RVT) combined with laparoscopic abdominal cerclage (LAC) offers a new fertility-sparing treatment for early cervical cancer. This approach successfully preserved fertility and led to successful pregnancies and deliveries in all patients.
Area of Science:
- Gynecology
- Surgical Oncology
- Reproductive Medicine
Background:
- Cervical cancer (CC) incidence in Slovenia was 13.2 per 100,000 women in 2011.
- Early-stage invasive cervical carcinoma treatment involves surgical techniques.
- A novel combination of fertility-preserving methods is presented.
Purpose of the Study:
- To present a new combination of surgical methods for fertility preservation in early cervical cancer.
- To improve pregnancy outcomes in patients treated for cervical cancer.
Main Methods:
- Radical vaginal trachelectomy (RVT) involves laparoscopic pelvic lymphadenectomy followed by vaginal removal of the cervix and parametria, with permanent cerclage.
- Laparoscopic abdominal cerclage (LAC) is a procedure using a Mersilene tape placed at the uterine isthmus.
- RVT was performed in 15 patients; 3 of them also underwent LAC.
Main Results:
- All three patients who underwent RVT and LAC achieved successful pregnancies.
- Deliveries occurred via cesarean section after 36 weeks of gestation in 100% of these cases.
Conclusions:
- Radical vaginal trachelectomy (RVT) is an indication for laparoscopic abdominal cerclage (LAC).
- Laparoscopic abdominal cerclage (LAC) should be performed proactively to prevent miscarriage, given its high success rate.
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