Robot-assisted, laparoscopic trans-abdominal cerclage (LAP-TAC) is a same-day, pre-pregnancy treatment that helps prevent pregnancy loss due to cervical insufficiency.
Ob/Gyn Scott Dinesen, DO, a member of Doylestown Hospital's medical staff and Robotics Committee chair, is one of the few physicians in the country who offer this minimally-invasive procedure to secure the cervix.
About the Cervix
The gateway from the womb to the vagina, the cervix remains closed during pregnancy, opening when it's time for the baby to pass through the birth canal. Unfortunately, in women who have weak cervical tissue, the cervix can open too soon. Known as incompetent or insufficient cervix, this condition leads to preterm labor and pregnancy loss.
What is a Cerclage?
Cerclage is a treatment for insufficient cervix. The physician secures the cervix with a stitch to help a woman carry her pregnancy to term.
Pre-pregnancy cerclage may be an option after:
- Multiple pregnancy losses
- A second trimester loss
- A past surgery weakened the cervical tissue
Benefits and Risks of Robotic Pre-Pregnancy Cerclage
Higher Success Rates
"Cerclage before pregnancy offers a success rate over 90 percent for full-term deliveries, and robot-assisted success rates are higher than with standard laparoscopic techniques,' says Dr. Dinesen.
Secure Stitch, No Bedrest
"Robotic technology enhances what we can do laparoscopically (through small incisions) offering added dexterity so we can place a more secure cerclage stitch. Patients who become pregnant after a LAP-TAC do not require bed rest.
Less Pain, Faster Recovery
"Tiny incisions mean less pain, and patients recover in 24 hours with no overnight hospital stay,' says Dr. Dinesen. "This is a huge improvement over the large abdominal incision and six-week recovery required with open surgery."
Risks
As with any surgery and anesthesia, there are risks. Though rare, these include bleeding, infection or damage to nearby tissue. Patients who have had pre-pregnancy cerclage require a cesarean delivery.
More About Robot-Assisted Surgery
At Doylestown Health, specially trained surgeons use the Intuitive da Vinci® Surgical System to provide minimally-invasive options for colon and rectal, general, gynecologic and urologic procedures.
The surgeon sits near the patient at an ergonomically designed console. A high-definition, three-dimensional camera provides clear views of the surgical field, and using joysticks or finger grips to maneuver robotic arms which offer a 360-degree range of motion (greater than the human hand) and allow the surgeon to control four instruments with two hands.
About Doylestown Health's VIA Maternity Center
Doylestown Health's VIA Maternity Center is rated among the best in the region for maternity care with services available for every stage of pregnancy through the birth experience. The VIA Maternity Center features a 32-bed maternity unit that includes 9 labor, delivery & recovery rooms, 22 private post-partum rooms, and a Level II Intensive Care Nursery staffed by neontologists from the Children’s Hospital of Philadelphia.
