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Minimally invasive abdominal cerclage compared to laparotomy: a comparison of surgical and obstetric outcomes

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Abstract

The objective of this study is to report surgical and obstetric outcomes of patients following abdominal cerclage placement through either minimally invasive or open techniques. Subjects of this retrospective cohort study were patients at two referral centers specializing in high-risk pregnancy and minimally invasive gynecologic surgery. Electronic medical records of all patients who underwent abdominal cerclage placement between December 2011 and December 2015 at Yale New Haven Hospital and Bridgeport Hospital were reviewed. The patients included were women who underwent abdominal cerclage placement either during pregnancy or prior to conception. One cohort of women had their abdominal cerclage placed using traditional laparoscopy or robotic-assisted laparoscopy. The other cohort consisted of women whose abdominal cerclage was placed through laparotomy. Electronic medical charts were reviewed to collect baseline demographic and pre-procedure obstetric information, as well as surgical and subsequent obstetric outcomes. Eleven minimally invasive and nine open abdominal cerclages were performed during the study period. Seven of the minimally invasive and two open cerclages were done outside of pregnancy. Average operative time was longer in the minimally invasive cohort. Estimated blood loss was typically lower in the minimally invasive group. Length of hospital stay was shorter in the minimally invasive group. Obstetric outcomes were similar between the two cohorts, with a total of nine live births in the minimally invasive group and seven live births in the open group. Minimally invasive abdominal cerclage is a safe alternative when performed by a surgeon with appropriate training and technical skills, and obstetric outcomes are comparable to those after open abdominal cerclage.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA

    Soorin Kim

  2. Section of Minimally Invasive and Robotic Surgery, Yale School of Medicine, Bridgeport Hospital, Bridgeport, CT, USA

    Amanda Hill

  3. Section of Gynecologic Oncology, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA

    Gulden Menderes & Masoud Azodi

  4. Section of Maternal Fetal Medicine, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA

    Sarah Cross & Mert Ozan Bahtiyar

Authors
  1. Soorin Kim
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  2. Amanda Hill
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  3. Gulden Menderes
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  4. Sarah Cross
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  5. Masoud Azodi
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  6. Mert Ozan Bahtiyar
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Corresponding author

Correspondence to Soorin Kim.

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Conflict of interest

The authors, Kim, Hill, Menderes, Cross, Azodi, and Bahtiyar declare that they have no conflict of interest.

Research involving human/animal participants

All human research was conducted in accordance with the ethical standards of the Institutional Review Board following approval from each hospital. This article does not contain any studies with animals performed by any of the authors.

Informed consent

This retrospective cohort study was exempt from a study-specific informed consent process by the Institutional Review Board.

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Kim, S., Hill, A., Menderes, G. et al. Minimally invasive abdominal cerclage compared to laparotomy: a comparison of surgical and obstetric outcomes. J Robotic Surg 12, 295–301 (2018). https://doi.org/10.1007/s11701-017-0726-9

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  • DOI: https://doi.org/10.1007/s11701-017-0726-9

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