New method for surgical treatment of uterine scar insuffisiency after a previous cesarean section using an intrauterine manipulator with a groove


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Abstract

Aim. The evaluation of the laparoscopic surgery for cesarean scar insufficiency after a previous cesarean section. Material and methods. Between 2018 and 2019, 15 patients with uterine scar dehiscence were managed at the department of operative gynecology, Federal State National Medical Research Center of Obstetrics, Gynecology and Perinatology named after. V.I. Kulakov, Russian Ministry of Helthcare. Results. A new method was developed for laparoscopic metroplasty of uterine scar insufficiency using a new intrauterine manipulator with a groove. The use of the new method resulted in the optimization of the insufficient scar excision, which is evaluated such surgical stages, as: scar incision; conjoin to connecting margins and myometrial suturing of all layers, for repair the complete myometrial segment, that allows for effective restoration of the lower uterine segment with the formation of a mature scar. Conclusion. The new intrauterine manipulator with a groove can be recommended for routine clinical application to optimize the management of uterine scar insufficiency after previous surgery.

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About the authors

Z. N Makiyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: makiyan@mail.ru
Principal Investigator, Doctor of medicine.

Leyla V. Adamyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: aleyla@inbox.ru
Academician of RAS, professor, doctor of medicine. Head op operative gynecology

Valeriy V. Karabach

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

MD, head of operation room

Vladimir D. Chuprynin

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of the Surgery Department

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