Abstract

This study seeks to reveal the indications, surgical techniques, and the impact of laparoscopic cervical cerclage on obstetric outcomes associated with a minimally invasive approach. This study is a retrospective review of patients who underwent laparoscopic transabdominal cervical cerclage procedures performed in a single center from January 2021 to April 2024. This included patients’ demographics and relevant obstetric & gynecological history, previous cervical cerclage, operative complications, operative times, average estimated blood loss, and subsequent obstetric outcomes. The study included 20 patients. These patients' surgery indications were: 15 patients (75%) had failed transvaginal cerclage, 3 (15%) had anatomical constraints that prevented placement, and 2 (10%) had cervical damage after vaginal delivery. Six patients (30%) became pregnant postoperatively. One person (16.6%) who became pregnant after surgery had an abortion. Our study defined success as 34 weeks of gestation and a healthy baby. We calculated 100% success using this criterion. Four (80%) of the patients who delivered delivered after 37 weeks, while 1 (20%) delivered between 34 and 37 weeks. Laparoscopic abdominal cerclage offers a good minimally invasive option for patients with a history of failed transvaginal cerclage or cervical insufficiency where transvaginal cerclage is not possible due to anatomic reasons or cervical damage. Laparoscopic abdominal cerclage appears to be a safe procedure when performed by individuals with the requisite skills and expertise in laparoscopy.

Key words: Cervical incompetence, laparoscopic abdominal cerclage, minimally invasive gynecology, preterm birth