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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
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Endoscopic transabdominal cervical cerclage replacement after recurrent late miscarriage
Martin Hirsch1, Dan Reisel2,3, Ertan Saridogan2,3
1Oxford Endometriosis CaRe Centre, Oxford University, Oxford, UK.
BMJ Case Reports
|March 1, 2022
Summary
Transabdominal cerclage (TAC) can fail due to suture migration. Laparoscopic removal and replacement of an open TAC successfully treated cervical weakness, enabling two term deliveries.
Area of Science:
- Reproductive Medicine
- Minimally Invasive Surgery
Background:
- Transabdominal cerclage (TAC) is a surgical procedure to prevent preterm birth caused by cervical weakness.
- TAC can be performed via open or laparoscopic approaches, with potential complications including failure and suture migration.
Observation:
- A patient with a history of recurrent miscarriages underwent an open TAC, which subsequently migrated through the cervix.
- The migrated cerclage necessitated removal and replacement.
Findings:
- Laparoscopic surgery was utilized for the removal of the open TAC.
- Following removal, the TAC was replaced, leading to successful term deliveries in subsequent pregnancies.
Implications:
- This case highlights the potential for TAC migration and the utility of laparoscopic techniques for managing such complications.
- Endoscopic management of TAC complications can improve pregnancy outcomes in women with cervical insufficiency.
