Laparoscopic transabdominal cerclage: new approach.
OBJECTIVE
To evaluate efficiency and safety of the new approach of laparoscopic cerclage.


METHODS
Fifteen women were operated with our new technique. Their age ranged from 22 years to 35 years. Inclusion criteria included those with history of two or more second trimesteric abortions or early preterm labor. These women had at least two previous unsuccessful vaginal cerclage or vaginal insertion of cerclage is not possible because of congenitally short cervix, cervical conization or excessive cervical scarring.


RESULTS
Twelve of the participants delivered vaginally with the removal of cerclage, two had CS due to breech presentation and the cerclage was left in place and the last one has surgical evacuation. No intraoperative or postoperative complications were encountered namely; excessive bleeding, injury of uterine vessels or postoperative peritonitis. No technical difficulties upon doing the procedure or cerclage removal were met apart from one case where removal of the vaginal stitch was not possible [incision was done in the cervix over the tape and the Mersilene tape was cut followed by repair of the cervical tissue using (00) Vicryl stitches].


CONCLUSIONS
The new approach for laparoscopic cerclage is a safe, effective and reasonable treatment after failure of vaginal cerclage.
a Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University , Cairo , Egypt.
Mohamed F
MF
Shaltout
a Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University , Cairo , Egypt.
Ahmed M
AM
Maged
a Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University , Cairo , Egypt.
Moutaz M
MM
Elsherbini
a Obstetrics and Gynecology Department, Kasr AlAiny Hospital, Cairo University , Cairo , Egypt.
Rasha O
RO
Elkomy
D000328:Adult; D023802:Cerclage, Cervical / Q000379:methods*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007752:Obstetric Labor, Premature; D011183:Postoperative Complications; D011247:Pregnancy; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000601:surgery*; D055815:Young Adult
Incompetent cervix; laparoscopy; transabdominal cerclage