Laparoscopic cervical cerclage
by Jain Nutan, Jain Vandana

Comprehensive Video Atlas of Laparoscopic Surgery in Infertility and Gynecology

by Nutan Jain
About Video

This video is a case of 32-years-old lady Present complaints video laparoscopy and hysteroscopy done for double vagina and double cervix with single fundus followed by septum resection two years back. Following which she got spontaneously pregnant after six months but aborted at 20 weeks of pregnancy with sudden leaking. No 8 Hegar dilator could be passed easily through the internal OS of cervix after 12 weeks postabortion. Sonography: uterus normal shape, size and position. Bilateral ovary and tubes normal. Preoperative diagnosis: cervical incompetence. Port placement: patient laid in modified lithotomy position under GA. Four ports laparoscopy done, all 5 mm ports except camera port which is 10 mm. Surgical procedure: uterus, bilateral tubes and ovaries normal. Anteriorly uterovesical fold of peritoneum and posteriorly pouch of Douglas was normal. RUMI uterine manipulator used for manipulation. Uterovesical fold of peritoneum opened with Harmonic ACE and is extended bilaterally to expose anterior cervical isthmus and bilateral uterine vessels. Mersilene tape, NW 22, 48 mm half circle round body double needle (Ethicon) introduced in the abdomen. One needle of Mersilene tape passed from posterior to anterior on right side in the isthmus part just medial to the uterine vessel. Another needle of Mersilene tape is passed from left side posteriorly to emerge anteriorly and medial to uterine vessel. Both the ends of tape tied and trimmed short. Defect of uterovesical fold of peritoneum closed with no 1-0 polygalyctin suture in continuous manner.

Report this Video

© 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved