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| Name | Laparoscopic Cerclage: Didelphys Uterus & Solitary Kidney |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 16-09-2024 20:11:23 |
| Video Discription | The video demonstrates the technique for laparoscopic abdominal cerclage in a patient with a didelphys uterus and a solitary kidney, highlighting key anatomical considerations and the surgical steps involved. See full transcript here: https://cansagevideos.com/laparoscopic-cerclage-didelphys-uterus-solitary-kidney/ Presented By Dr. Angela Johnston Dr. Neeraj Mehra Affiliations University of British Columbia Timestamps (00:08) Objectives (00:42) Abdominal Cerclage (01:26) Ultrasound (01:33) Planning for Future Pregnancy (01:59) Surgical Steps (02:11) Right Tubal Ostia (02:19) Cystoscopy by Urology (03:00) Laparoscopy with Transabdominal Cerclage (06:08) Follow-Up This video presents a step-by-step guide to performing a laparoscopic abdominal cerclage in a patient with a didelphys uterus and a solitary kidney. The patient, a 33-year-old woman, had a complex obstetrical history, including previous cervical insufficiency and unsuccessful vaginal cerclage, which led her to opt for an abdominal cerclage for future pregnancies. A laparoscopic approach was chosen due to its minimally invasive nature and better recovery outcomes compared to open surgery. The procedure began with a diagnostic hysteroscopy and cystoscopy to evaluate the patient’s anatomy, including her solitary kidney. A stent was placed in the left ureter to avoid injury during the cerclage procedure. Laparoscopic entry revealed two normal-sized uteri and adhesions between the rectosigmoid mesentery and the uteri, which were cleared to allow for cerclage placement. The cerclage suture was placed around both cervixes at the cervical isthmus, medial to the uterine vessels. Windows were created in the broad ligament on both sides, and a bladder flap was reflected to allow room for suture placement. The suture was passed through the umbilical port and tied posteriorly using a sliding knot technique. The final inspection confirmed that the cerclage was placed safely, away from the bladder and ureters, with adequate hemostasis. The patient tolerated the procedure well, with minimal blood loss. She later conceived spontaneously and delivered via emergency cesarean section at 33+3 weeks gestational age due to preterm labor. This case highlights the successful use of laparoscopic abdominal cerclage in complex anatomical cases, demonstrating the importance of careful planning and anatomical knowledge to avoid complications. |
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