Removal of an Abdominal Cerclage by Colpotomy: A Novel and Minimally Invasive Technique

• Published in: Journal of minimally invasive gynecology Vol. 27; no. 7; pp. 1636 - 1639
• Main Authors: Burger, Nicole B., van ‘t Hof, Eline M., Huirne, Judith A.F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2020
• Subjects: Abdomen - pathology; Abdomen - surgery; Abdominal cerclage; Adult; Anterior colpotomy; Cerclage; Cerclage, Cervical - adverse effects; Cerclage, Cervical - instrumentation; Cerclage, Cervical - methods; Colpotomy - instrumentation; Colpotomy - methods; Delivery, Obstetric; Device Removal - methods; Female; Humans; Infant, Newborn; Laparoscopy - instrumentation; Laparoscopy - methods; Minimally Invasive Surgical Procedures - methods; Posterior colpotomy; Pregnancy; Pregnancy Complications - surgery; Pregnancy Trimester, Second; Removal; Sutures - adverse effects; Treatment Outcome; Uterine Cervical Incompetence - surgery; Removal; Anterior colpotomy; Cerclage; Posterior colpotomy; Abdominal cerclage
• ISSN: 1553-4650; 1553-4669
• DOI: 10.1016/j.jmig.2020.05.022

Abdominal cerclage is an effective treatment for cervical incompetence in patients with a previously failed vaginal cerclage or with anatomic restrictions to a vaginal cerclage. Management of second trimester complications that warrant a delivery impose a complex clinical situation in patients with an abdominal cerclage. We report 3 cases of successful removal of an abdominal cerclage by posterior and anterior colpotomy in the second trimester of pregnancy. This new and minimally invasive surgical technique avoids the need for extensive dilation, laparoscopy, or laparotomy to remove the cerclage and allow a vaginal delivery.