Transabdominal cerclage: A laparoscopic approach

Background: The placement of a transabdominal cervical cerclage has been regarded as considerably more morbid than a transvaginal cerclage, in part due to the need for two laparotomies. We describe a technique for the laparoscopic placement and removal of a transabdominal cerclage. Cases: Two cases of women with insufficient cervical tissue to place a transvaginal cerclage were managed with a transabdominal cerclage. In one case, the cerclage was placed laparoscopically; in the other, the band was removed, facilitating uterine evacuation following the diagnosis of a missed abortion. In both cases a laparotomy was avoided. Conclusion: Laparoscopic placement and removal of a transabdominal cerclage are promising options in the treatment of an incompetent cervix. (C) 1998 by The American College of Obstetricians and Gynecologists.