Innovative Surgical Approach for Cervical Insufficiency and Uterovaginal Prolapse: Laparoscopic Transabdominal Cerclage with Sacrocervicopexy Using Single Polyester Tape
B Ramesh, Kiran R Konda, Priyanka Das, Priya SP Patil, Sanghamita Rangaswamy
Citation Information :
Ramesh B, Konda KR, Das P, Patil PS, Rangaswamy S. Innovative Surgical Approach for Cervical Insufficiency and Uterovaginal Prolapse: Laparoscopic Transabdominal Cerclage with Sacrocervicopexy Using Single Polyester Tape. World J Lap Surg 2024; 17 (2):130-133.
Aim and background: This case report documents the management of a 32-year-old female with a history of precipitate labor, failed cervical cerclage, and recurrent pregnancy losses with 2nd degree uterovaginal prolapse. The patient was counseled for a laparoscopic transabdominal cerclage and sacrocervicopexy to address cervical insufficiency and uterovaginal prolapse in single setting.
Case description: A laparoscopic procedure where transabdominal cerclage with sacrocervicopexy with a single polyester tape was done. Postoperative recovery was uneventful, and the patient was discharged after 48 hours.
Conclusion: This case report highlights a novel approach to managing complex obstetric issues, offering step-by-step guide to successful application of laparoscopic transabdominal cerclage and sacrocervicopexy for patients with recurrent pregnancy loss and uterovaginal prolapse using single polyester tape.
Clinical significance: This is a novel single setting procedure to combat cervical insufficiency and uterovaginal prolapse using single polyester tape with several advantages over conventional treatment options available.
Sharma JC, Sarkar A, Choudhary N, et al. Laparoscopic sacrocervicopexy using ethibond suture graft: A very economic yet effective fertility preserving surgery for pelvic organ prolapse. Cureus 2022;14(12):e33086. DOI: https://doi.org/10.7759/CUREUS.33086.
Busby G, Broome J. Successful pregnancy outcome following laparoscopic sacrohysteropexy for second degree uterine prolapse. Gynecol Surg 2010;7(3):271–273. DOI: https://doi.org/10.1007/s10397-008-0460-4.
Clark NV, Einarsson JI. Laparoscopic abdominal cerclage: A highly effective option for refractory cervical insufficiency. Fertil Steril 2020;113(4):717–722. DOI: https://doi.org/10.1016/J.FERTNSTERT. 2020.02.007.
Kow N, Goldman HB, Ridgeway B. Management options for women with uterine prolapse interested in uterine preservation. Curr Urol Rep 2013;14(5):395–402. DOI: https://doi.org/10.1007/S11934-013-0336-7.
Ramesh B, Akshaya S, Das P, et al. A retrospective study comparing laparoscopic transabdominal cerclage: Pre-pregnancy vs. in pregnancy with their reproductive outcomes and safety. J Obstet Gynaecol 2023;102267. DOI: https://doi.org/10.1016/j.jogc.2023. 102267. Published on: 6 November 2023.
Ben-Zvi M, Herman HG, Bar J, et al. Are women with cervical incompetence at a higher risk of experiencing urinary and pelvic organ prolapse symptoms? Int Urogynecol J 2020;31(2):385–389. DOI: https://doi.org/10.1007/S00192-019-03979-W.
Berghella V, Szychowski JM, Owen J, et al. Suture type and ultrasound-indicated cerclage efficacy. J Matern Fetal Neonatal Med 2012;25(11):2287–2290. DOI: https://doi.org/10.3109/14767058.2012.688081.
Alas QMDA, Lee CL, Kuo HH, et al. Interval laparoscopic transabdominal cervical cerclage (ILTACC) using needleless mersilene tape for cervical incompetence. Gynecol Minim Invasive Ther 2020;9(3): 145–149. DOI: https://doi.org/10.4103/GMIT.GMIT_90_19.
Rosati M, Bracale U, Bramante S, et al. Efficacy of laparoscopic sacrocervicopexy for apical support of pelvic organ prolapse. JSLS 2013;17(2):235–244. DOI: https://doi.org/10.4293/108680813X13654754535115.
Sutaria AD, Bhedi AN, Sindhal ML, et al. Comparative study of polyester vs polypropylene mesh in laparoscopic inguinal hernia repair. Int Surg J 2019;6(2):531–536. DOI: https://doi.org/10.18203/2349-2902.ISJ20190398.
