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Surakshith L Gowda 10.5005/jp-journals-10033-1277
REVIEW ARTICLE

Transabdominal Cervical Cerclage: Laparoscopy

or Laparotomy

Surakshith L Gowda

ABSTRACT the level of the inner cervical os, while the McDonald
Cervical incompetence is one of the common causes of recurrent “purse string” procedure includes embedding the line
2
pregnancy loss. Transabdominal cervical cerclage is the option around the intravaginal segment of the cervix. The
where previous vaginal cerclages have failed or in patients with procedure is normally performed toward the end of
congenital short or absent cervix, a lacerated cervix, severe the first trimester or the start of the second trimester,
scarring of the cervix, and multiple deep cervical defects. So
this review is aimed to study the effectiveness of laparoscopic and the stitch is generally removed at term. In the event
cerclage in comparison with cervical cerclage by laparotomy. A lit- that a past transvaginal cervical cerclage has fizzled or
erature search was performed using Springer link, BMJ, Journals it is not actually conceivable (for instance, if the cervix
of Minimal Access Surgery, and major general search engines is short), a transabdominal method might be utilized.
like Google, MSN, HighWire Press, and Yahoo. The stu dies
between 2000 and 2015 were selected and were reviewed for This ordinarily includes a laparotomy to put the stitch
the prolongation of pregnancy, intraoperative and postoperative around the cervix and cesarean section is performed to
complications, operating time, blood loss, postoperative recov- deliver the baby. 1,2
ery in both the laparoscopic and open procedure. The review With the increase of laparoscopic potential outcomes,
concludes that if transabdominal cervical cerclage is preferred laparoscopic transabdominal cerclage (TAC) turned
then laparoscopic approach is superior to laparotomy as it is
as effective as open method with fast postoperative recovery. into a choice. This strategy is ideally performed in
the nonpregnant state and has the upside of shorter
Keywords: Abdominal cerclage, Cervical cerclage, Cervical hospitalization and speed recovery with less postoperative
incompetence, Cervical stitch, Laparoscopic cerclage,
3,4
Laparotomy, Recurrent pregnancy loss. morbidity. So this review is aimed to study the
effectiveness of laparoscopic cerclage in comparison with
How to cite this article: Gowda SL. Transabdominal Cervical
Cerclage: Laparoscopy or Laparotomy. World J Lap Surg cervical cerclage by laparotomy.
2016;9(2):78-81.
AIM
Source of support: Nil
The aim of this study was to compare the effectiveness
Conflict of interest: None
and safety of laparoscopic cervical cerclage vs TAC by
laparotomy.
INTRODUCTION
The American College of Obstetricians and Gynecologists MATERIALS AND METHODS
(ACOG) defines cervical incompetence as the inability A literature search was performed using Springer link,
of the uterine cervix to retain a pregnancy in the second BMJ, Journals of Minimal Access Surgery, and major
1
trimester, in the absence of uterine contractions. Cervical general search engines like Google, MSN, HighWire Press,
incompetence is customarily treated by transvaginal Yahoo, etc. The following search terms were used: Lapa-
cervical cerclage, which is normally done under general roscopic cerclage, recurrent pregnancy loss, abdominal
or regional anesthesia. There are two primary strategies: cerclage, cervical incompetence, laparoscopy, laparotomy,
The Shirodkar method includes putting the stitch high and cervical stitch. The studies between 2000 and 2015 were
up around the cervix, as close as would be prudent to selected and those studies which compared the outcomes
after third trimester were selected for review. Prolongations
of pregnancy, intraoperative and postoperative complica-
Assistant Professor
tions, operating time, blood loss, postoperative recovery
Department of Obstetrics and Gynecology, Adichunchanagiri were the parameters evaluated for the effectiveness and
Institute of Medical Sciences and Research Centre, Bellur safety of the laparoscopic and open procedure.
Karnataka, India
Corresponding Author: Surakshith L Gowda, Assistant Professor RESULTS
Department of Obstetrics and Gynecology, Adichunchanagiri
Institute of Medical Sciences and Research Centre, Bellur The available literature consists of cohort studies, small
Karnataka, India, e-mail: surakshithlgowda@gmail.com
case series, and also some case reports. Fifteen articles
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