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Laparoscopic cervical cerclage for cervical incompetence

Cervical incompetence refers to weakness in cervix that causes miscarriage usually in the second trimester.It affects 2%of pregnancies. The weakness is usually due to previous surgical interventions on the cervix such as conization for cervical dysplasia (pre-cancerous condition) and on occasions with no specific causes.

The usual managemnt is to strengthen the cervix by placing a tape around the cervical canal. This is usually done using a vaginal approach.

But on occasions, and in particular after placement of several cerclages during several pregnancies, the vaginal part of the cervix becomes scarred and shortened and does not allow placement of any more cerclages via the vaginal approach. In such situation, the cerclage tape may be placed via the laparoscope. The following video is for such a procedure performed byDr. Badran for a patient who is pregnant 8 weeks and had multiple previous miscarriages due to cervical incompetence and inspite of placement of vaginal cerclages.