Tips and tricks for laparoscopic interval transabdominal cervical cerclage; a simplified technique

Area of Science:

• Minimally Invasive Surgery
• Gynecology
• Maternal-Fetal Medicine

Background:

• Laparoscopic cervical cerclage offers minimally invasive options for preventing preterm birth.
• Existing techniques have shown promising outcomes, driving innovation in surgical approaches.

Purpose of the Study:

• To describe a simplified laparoscopic interval transabdominal cervical cerclage technique.
• To highlight the advantages of using straightened needles and posterior knot placement.

Main Methods:

• A simplified laparoscopic interval transabdominal cervical cerclage is detailed.
• Standard non-absorbable Mersilene tape is used as the suture material.
• Straightened needles are passed medial to uterine vessels, lateral to the cervico-isthmic junction, and tied posteriorly.

Main Results:

• The technique facilitates easy insertion through 5-mm ports.
• Accurate anteroposterior suture direction is achieved.
• Posterior knots allow for removal via colpotomy if pregnancy fails, potentially enabling vaginal delivery.

Conclusions:

• This simplified laparoscopic cervical cerclage technique is effective and minimally invasive.
• The described method offers advantages in suture placement and management of pregnancy complications.
• Further studies may validate its efficacy in preventing preterm birth.