Robotic or laparoscopic treatment of cesarean scar defects or cesarean scar pregnancies with a uterine sound guidance

Taiwan J Obstet Gynecol. 2021 Sep;60(5):821-826. doi: 10.1016/j.tjog.2021.07.007.

Abstract

Objective: To evaluate the feasibility and effectiveness of robotic/laparoscopic repair of cesarean scar defects or cesarean scar pregnancies with a uterine sound.

Materials and methods: All consecutive women with cesarean scar defects or cesarean scar pregnancies who underwent robotic/laparoscopic repair with a bent uterine sound guidance were reviewed. Subjective changes in symptoms and objective changes in the depth and width of cesarean scar defects after surgery were reviewed.

Results: A total of 20 women underwent robotic (n = 3) or conventional laparoscopic (n = 17) repair of cesarean scar defects, which included postmenstrual vaginal bleeding associated with cesarean scar defects (n = 15), cesarean scar pregnancies (n = 3), accumulated pus in the cesarean scar defect (n = 1) and an incomplete abortion incarcerated in the cesarean scar defect (n = 1). Bladder perforation occurred in one woman during robotic adhesiolysis. All women with cesarean scar defects (n = 15) reported an improvement in postmenstrual vaginal bleeding after surgery. Follow-up sonography showed a decrease in the depth and width of the cesarean scar defect and an increase in the residual myometrial thickness.

Conclusion: Robotic or laparoscopic repair with a uterine sound guidance seems to be a feasible and effective method in the treatment of cesarean scar defect or cesarean scar pregnancy.

Keywords: Cervix; Cesarean section; Ectopic; Laparoscopy; Robotics.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cicatrix / complications
  • Cicatrix / etiology
  • Cicatrix / pathology
  • Cicatrix / surgery*
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Middle Aged
  • Pregnancy
  • Pregnancy, Ectopic / etiology
  • Pregnancy, Ectopic / surgery*
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • Uterine Hemorrhage / surgery*