First Trimester Laparoscopic Cerclage

Journal of Minimally Invasive Gynecology
Linda-Dalal ShiberResad Pasic

Abstract

To review the indications, rationale, and technique for abdominal cerclage, specifically focusing on a laparoscopic approach to this procedure during the first trimester of pregnancy. This is an educational video directed toward gynecologic surgeons. Patient consent was obtained for use of surgical video footage, and Institutional Review Board exemption was granted. A patient case is discussed and a step-by-step description of the technique used to perform laparoscopic cerclage in the first trimester of pregnancy is demonstrated using surgical footage. The estimated incidence of cervical insufficiency affecting pregnancy is as high as 1%. Cervical cerclage placement is the treatment for this condition. Although most cerclages are placed transvaginally via the Shirodkar or McDonald technique, abdominal cerclage is necessary in women with a previous failed transvaginal cerclage or in those with minimal cervical tissue accessible vaginally [1,2]. Both laparoscopic and robotic approaches to this procedure have been developed, allowing patients to enjoy a more rapid recovery as well as to avoid an unnecessary laparotomy[3-6]. The observational studies reporting outcomes for laparoscopic-assisted abdominal cerclage quote fetal surviv...Continue Reading

References

Oct 22, 2003·The Journal of the American Association of Gynecologic Laparoscopists·Chi-Heum ChoSoon-Do Cha
Sep 29, 2004·Obstetrics and Gynecology Clinics of North America·Raedah Al-Fadhli, Togas Tulandi
Mar 28, 2008·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Geoffrey D ReidPeter Hammill
Apr 29, 2008·Journal of Minimally Invasive Gynecology·Hilary S Liddell, Chern Lo
Jul 7, 2009·American Journal of Obstetrics and Gynecology·James F CarterJ Peter Van Dorsten
Oct 1, 2009·American Journal of Obstetrics and Gynecology·Wendy L WhittleNicholas Leyland
Oct 26, 2011·Journal of Minimally Invasive Gynecology·N B BurgerJ A F Huirne
Aug 28, 2012·American Journal of Obstetrics and Gynecology·Nicole B BurgerJudith A F Huirne
Sep 5, 2012·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·E S MooreJ E Sumners
Dec 22, 2012·Gynecologic and Obstetric Investigation·Sherif A El-NasharMohamed A Bedaiwy
Dec 24, 2013·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Alex AdesMark P Umstad
Jun 8, 2014·Journal of Minimally Invasive Gynecology·Togas TulandiXianming Tan
Jun 27, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Lu LuoShu-zhong Yao
Sep 30, 2016·Journal of Minimally Invasive Gynecology·D Nahar, M L Nimaroff

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Citations

Mar 16, 2018·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·K IchizukaM Nagatsuka

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