Tips and tricks for laparoscopic interval transabdominal cervical cerclage; a simplified technique.

With the advance of laparoscopic surgery, several minimally invasive cervical cerclage techniques have been described and the outcomes of those have been promising. With this video article, we describe a simplified technique for laparoscopic interval transabdominal cervical cerclage. The suture material is a standard non-absorbable, braided polyester Mersilene tape, which is also used for transvaginal cerclage. The straightened needle is passed medial to the uterine vessels and lateral to the cervico-isthmic junction in anteroposterior direction on both sides, and pulled out above the uterosacral ligament. The knot is tied posteriorly, just above the uterosacral plate. The advantages of straightened needles are easy insertion into the abdominal cavity through the 5-mm ports, and more accurate direction of the suture in anteroposterior direction. In addition, posterior knots can be removed via colpotomy in the event of pregnancy failure in the second trimester, and this allows vaginal delivery.