Laparoscopic repair of wide and deep uterine scar dehiscence after cesarean section

Abstract

Objective: To propose a new laparoscopic technique for repair of scar dehiscence after cesarean section.

Design: The dehiscent scars were evaluated by ultrasound, hysterography, hysteroscopy, and magnetic resonance imaging. The results were correlated with those after laparoscopic repair.

Setting: University hospital.

Patient(s): Three patients underwent cesarean section and presented with symptomatic dehiscence at the level of the incision.

Intervention(s): Laparoscopic repair of the dehiscence, including excision of the fibrotic tissue and laparoscopic closure of the anterior uterine wall.

Main outcome measure(s): Evaluation by ultrasound and magnetic resonance imaging of the sagittal depth of the scar and the thickness of the residual myometrium covering the dehiscence.

Result(s): The defect was completely corrected by laparoscopic repair in all cases.

Conclusion(s): Evaluation of uterine scar dehiscence after cesarean section can be performed by ultrasound and magnetic resonance imaging, and laparoscopic surgical repair may be performed with good postoperative anatomic outcomes.