Up to 90% success with Laparoscopic Suture (cerclage) in recurrent cervical insufficiency

Cervical insufficiency usually develops between 16 to 24 weeks of gestation and causes miscarriage or very premature births as a result of the opening of the cervix painlessly. The 

diagnosis can often be made after the loss of the first pregnancy.

In the treatment of cervical insufficiency, cerclage, in other words, suturing of the cervix, should be planned during the weeks 13 and 14 of gestation, before the cervix begins to open. The first preferred method is cerclage via vaginal way. However, in some special cases, cerclage can be performed openly or preferably laparoscopically, that is, closed, by making an incision in the abdomen that matches the region of the cesarean section.

When should laparoscopic cerclage be planned?

In cases where vaginal cerclage failed in previous pregnancies (at least 2 times)

In cases where the cervix is very short or irregular

In patients who have had a large part of the cervix removed due to early cervical cancers or dysplasia

When should laparoscopic cerclage be planned?
Before pregnancy, the period when the uterus is small and blood supply is low is the most appropriate time. Pregnancy is recommended 6 weeks after the procedure. If there is an existing pregnancy, the procedure can be performed in the first 3 months of pregnancy.

What are the advantages of laparoscopic cerclage?
With this method, it is possible to reach much higher parts of the cervix and suture it.

It can easily be performed using 3 small holes without the need for a cut like a cesarean section.
The patient can be discharged the same day at night.
Delivery occurs 90% after the 34th week of pregnancy.
Suturing never prevents you from getting pregnant.
Sutures are left in their places after birth, thus they can be used again in following births. 

You can watch the speech of Prof.Dr.Yücel Karaman about this topic in the video below.

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