Page 32 - World Journal of Laparoscopic Surgery

Surakshith L Gowda
manipulation. The peritoneal cavity is first insufflated TAC. By and large, one can say that this minimal-invasive
with carbon dioxide through a Veress needle inserted method has good success rate and minimal co-morbidities
into the umbilicus. Optical and secondary ports are cre- with less complication.
ated to provide access for the laparoscope and surgical
instruments. The bladder is dissected away from the CONCLUSION
uterus and a ligature of tape or mesh is secured around Transabdominal cervical cerclage could be either pro-
the cervical isthmus, above the cardinal and uterosacral phylactic or indicated, but has a higher success rate.
ligaments. As with the open transabdominal approach, Transabdominal cerclage cannot be compared with the
cesarean section is necessary to deliver the baby. 1-3 transvaginal cerclage as the indications and situations of
The transabdominal cervical cerclage can be done both the procedure differ and also the transabdominal
as a prophylactic procedure or as an indicated one. The procedure gives an additional advantage to perform
specific indications include those people in whom an concomitant surgery along with the cerclage. Laparo-
agreeable transvaginal cerclage is not actually feasible scopic approach for TAC is as effective as the laparotomy
with a congenital short or absent cervix, a lacerated cervix, and can be safely performed during pregnancy also.
severe scarring of the cervix, and multiple deep cervical Laparoscopic method is preferred over laparotomy as it
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defects. Likewise, a past fizzled vaginal cerclage has is associated with less or no hospitalization, less postop-
been regarded as an indication for a TAC. 9,20 Some studies erative pain, and quicker recovery so that the morbidity
researched the adequacy of a prophylactic cerclage after associated with laparotomy can be prevented.
cervical conization for decreasing the danger of preterm
delivery. Regardless of the rise in the rate of preterm de- REFERENCES
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