Fertility and sterility · 2026
Laparoscopic abdominal cerclage at 15 weeks of gestation after trachelectomy: a step-by-step surgical video.
СтатьяVideo-Audio MediaКлинический случайНазвание и аннотация: Перевод в очереди
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Bernigaud Oriane, Arendas Kristina, Paulus Azélie, Lemyre Madeleine, Maheux-Lacroix Sarah
Аннотация
OBJECTIVE: To demonstrate the surgical technique of laparoscopic abdominal cerclage at 15 weeks of gestation in a patient with a history of radical trachelectomy.
DESIGN: Video article with intraoperative narration and key surgical highlights.
SUBJECTS: A 37-year-old woman, gravida 2 para 0, had a history of radical trachelectomy for early-stage cervical cancer. After in vitro fertilization, she presented at 15 weeks of gestation with a short cervix (17 mm) and insufficient cervical tissue for vaginal cerclage.
EXPOSURE: Laparoscopic abdominal cerclage was performed at a tertiary academic center specializing in minimally-invasive gynecologic surgery.
MAIN OUTCOME MEASURES: The patient delivered a healthy infant via cesarean section at 36 weeks after premature rupture of membranes. The cerclage was left in place for future pregnancies.
RESULTS: A four-step laparoscopic approach was used: abdominal entry via the Hasson technique and trocar placement adapted to the gravid uterus, dissection of the vesicouterine peritoneum and broad ligaments to identify the uterine arteries, placement of a nonabsorbable suture medial to the uterine arteries at the isthmus level, and suture fixation using a Roder knot and peritonealization. Tips for managing intraoperative bleeding and optimizing exposure are discussed.
CONCLUSION: Laparoscopic abdominal cerclage during pregnancy may be considered a feasible and relatively safe approach in selected high-risk patients. This video provides a clear and structured guide for surgeons managing posttrachelectomy pregnancies.
DESIGN: Video article with intraoperative narration and key surgical highlights.
SUBJECTS: A 37-year-old woman, gravida 2 para 0, had a history of radical trachelectomy for early-stage cervical cancer. After in vitro fertilization, she presented at 15 weeks of gestation with a short cervix (17 mm) and insufficient cervical tissue for vaginal cerclage.
EXPOSURE: Laparoscopic abdominal cerclage was performed at a tertiary academic center specializing in minimally-invasive gynecologic surgery.
MAIN OUTCOME MEASURES: The patient delivered a healthy infant via cesarean section at 36 weeks after premature rupture of membranes. The cerclage was left in place for future pregnancies.
RESULTS: A four-step laparoscopic approach was used: abdominal entry via the Hasson technique and trocar placement adapted to the gravid uterus, dissection of the vesicouterine peritoneum and broad ligaments to identify the uterine arteries, placement of a nonabsorbable suture medial to the uterine arteries at the isthmus level, and suture fixation using a Roder knot and peritonealization. Tips for managing intraoperative bleeding and optimizing exposure are discussed.
CONCLUSION: Laparoscopic abdominal cerclage during pregnancy may be considered a feasible and relatively safe approach in selected high-risk patients. This video provides a clear and structured guide for surgeons managing posttrachelectomy pregnancies.