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Laparoscopic abdominal cerclage during pregnancy: a simplified approach
Baihui Zhao1, Tian Dong1, Yuan Chen1
1Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.
American Journal of Obstetrics and Gynecology
|March 27, 2022
Summary
A novel laparoscopic technique for transabdominal cerclage (TAC) offers a safe and effective solution for cervical insufficiency during early second-trimester pregnancy. This needle-free approach successfully prevented pregnancy loss in all treated patients.
Area of Science:
- Obstetrics and Gynecology
- Minimally Invasive Surgery
- Maternal-Fetal Medicine
Background:
- Cervical insufficiency is a significant cause of pregnancy loss and preterm birth.
- Transabdominal cerclage (TAC) is typically performed before pregnancy.
- Performing TAC during pregnancy presents surgical challenges due to uterine enlargement.
Purpose of the Study:
- To describe an easy and effective laparoscopic technique for transabdominal cervicoisthmic cerclage during early second-trimester pregnancy.
- To evaluate the safety and efficacy of this novel needle-free procedure.
Main Methods:
- A laparoscopic approach using 4 trocars was established.
- A needleless Mersilene tape was inserted via the broad ligaments, avoiding bladder dissection.
- The tape was secured with intracorporeal knots, guided by transvaginal ultrasound.
Main Results:
- The procedure was performed on 10 patients indicated for TAC during early second-trimester pregnancy.
- No pregnancy losses were observed in the study cohort.
- The technique demonstrated accessibility and effectiveness with positive outcomes.
Conclusions:
- Needle-free laparoscopic trans-broad-ligament cervicoisthmic cerclage is an accessible and effective surgical option.
- This technique offers a viable solution for patients requiring TAC during early second-trimester pregnancy.
- The procedure shows an affirmative prognosis for preventing pregnancy loss.
