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MainMINIMALLY INVASIVE PROCEDURESGynecologyUterine cervix diseasesCerclage of uterus

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Laparoscopy. Preconceptional cervical cerclage

Professor Popov A.A. is performing an operation (2016)

In this video the technique of laparoscopy- cerclage of uterus-is presented. Vesicouterine folds are opened, the urinary bladder is mobilized. The space between uterine cervix and ascending branches of the uterine artery is exposed. A synthetic prosthesis is used-mercilene band, having the length 40 cm, the width-5 mm, and two cutting needles at the ends. The needles are straightened extracorporeally, are inserted through a 6 mm central troacar. The needles are passed between the uterine cervix and the uterine artery in the direction from front backward. Pricking out of the needle is done at the level of the sacrouterine ligaments. It is a supposed level of the internal fauces. Ligatures are bound at the stretched position. The occlusion of the cervical canal does not take place as the prosthesis is located around the uterine cervix. Peritonization is in the anterior area due to the vesicouterine folds. Posterior peritonization is not performed. But conditions for colpotomy performing, dissection and removal of prosthesis are created: if there is a necessity to remove prosthesis in case of development of obstetrician complications and if there is a necessity for emptying the uterine cavity. During cesarean sections we have not found out adhesions near the prosthesis (N=37).

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