title: A novel method for laparoscopic abdominal cerclage utilizing minimally invasive hydrodissection: a case report.
abstract: BACKGROUND
  Cervical incompetence can lead to the inability to sustain an intrauterine pregnancy and may account for a substantial portion of second-trimester losses. Placement of a transvaginal cerclage has been shown to decrease morbidity in a substantial number of such cases. In patients lacking sufficient cervical tissue, a cerclage may be placed by a transabdominal approach. This procedure carries risks of significant morbidity to the maternal-fetal unit if done by laparotomy.
  
  
  METHODS
  A 22-year-old gravida at 13 weeks' gestation with a past history significant for cervical incompetence and absence of cervical tissue underwent placement of an abdominal cerclage. We utilized laparoscopic operative techniques and employed hydrodissection to decrease manipulation and bleeding around the gravid uterus.
  
  
  CONCLUSIONS
  A laparoscopic approach to cerclage in patients diagnosed with cervical incompetence can be performed with minimal risks to the gravid uterus.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, Hackensack University Medical Center, Hackensack, New Jersey, USA. ramziajaoude@hotmail.com
authors.forename: Ramzi
authors.initials: R
authors.lastname: Aboujaoude
authors.forename: Paul
authors.initials: P
authors.lastname: Maloof
authors.forename: Manuel
authors.initials: M
authors.lastname: Alvarez
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al Khan
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D002581:Uterine Cervical Incompetence / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*