Fertility and sterility · 2025
A novel approach for cesarean scar defect repair: translating hysteroscopic markings into laparoscopic precision with the Taurus T method.
СтатьяКлинический случайVideo-Audio MediaНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sako Yusuke, Hirata Tetsuya
Аннотация
OBJECTIVE: To present the "Taurus T Method," a novel 3-step approach that simplifies our previously reported nonperfusion hysteroscopy technique for cesarean scar defect (CSD) repair by eliminating the need for simultaneous screen monitoring.
DESIGN: A technical video introducing the laparoscopic repair of CSD using the "Taurus T Method." This study was approved by the institutional review board (approval number: R22-093).
SUBJECTS: A 35-year-old woman presented with secondary infertility after a cesarean section performed 3 years ago at 38 weeks of gestation because of breech presentation. She underwent 4 cycles of intrauterine insemination and 4 embryo transfers via in vitro fertilization for unexplained infertility, but none resulted in pregnancy. During infertility treatment, she experienced irregular bleeding, and ultrasonography revealed blood pooling in the CSD.
EXPOSURE: The "Taurus T Method" involves 3 key surgical steps: Step 1: Under hysteroscopic guidance, mark the cephalad and caudal ends of the defect with straight needles. Step 2: Insert a Hegar dilator into the defect and bend the uterine fundus dorsally to achieve a retroverted position. This procedure generates the "Taurus sign," ensuring optimal uterine positioning for the resection of the CSD lesion within the laparoscopic field of view. Step 3: Perform a T-shaped excision between the needles: a vertical incision followed by a horizontal cut along the cephalad margin. The needle markings translate hysteroscopic findings into a laparoscopic view, allowing surgeons to focus on the laparoscopic screen during the excision phase.
MAIN OUTCOME MEASURES: Complete excision of the CSD and improvement in patient symptoms through the 3-step surgical technique.
RESULTS: The "Taurus T Method" achieved accurate CSD excision, although recognizing both the vertical and lateral extent through the laparoscopic view minimizing unnecessary tissue removal.
CONCLUSION: The "Taurus T Method" is a systematic approach for accurately identifying and removing the CSD. The "Taurus sign" enables recognition of the defect's vertical extent, whereas the T-shaped incision allows precise visualization of its lateral extent, ensuring complete excision.
DESIGN: A technical video introducing the laparoscopic repair of CSD using the "Taurus T Method." This study was approved by the institutional review board (approval number: R22-093).
SUBJECTS: A 35-year-old woman presented with secondary infertility after a cesarean section performed 3 years ago at 38 weeks of gestation because of breech presentation. She underwent 4 cycles of intrauterine insemination and 4 embryo transfers via in vitro fertilization for unexplained infertility, but none resulted in pregnancy. During infertility treatment, she experienced irregular bleeding, and ultrasonography revealed blood pooling in the CSD.
EXPOSURE: The "Taurus T Method" involves 3 key surgical steps: Step 1: Under hysteroscopic guidance, mark the cephalad and caudal ends of the defect with straight needles. Step 2: Insert a Hegar dilator into the defect and bend the uterine fundus dorsally to achieve a retroverted position. This procedure generates the "Taurus sign," ensuring optimal uterine positioning for the resection of the CSD lesion within the laparoscopic field of view. Step 3: Perform a T-shaped excision between the needles: a vertical incision followed by a horizontal cut along the cephalad margin. The needle markings translate hysteroscopic findings into a laparoscopic view, allowing surgeons to focus on the laparoscopic screen during the excision phase.
MAIN OUTCOME MEASURES: Complete excision of the CSD and improvement in patient symptoms through the 3-step surgical technique.
RESULTS: The "Taurus T Method" achieved accurate CSD excision, although recognizing both the vertical and lateral extent through the laparoscopic view minimizing unnecessary tissue removal.
CONCLUSION: The "Taurus T Method" is a systematic approach for accurately identifying and removing the CSD. The "Taurus sign" enables recognition of the defect's vertical extent, whereas the T-shaped incision allows precise visualization of its lateral extent, ensuring complete excision.