A laparoscopic transabdominal cerclage (TAC) is a surgical procedure used to help prevent pregnancy loss or very early preterm birth in women with cervical insufficiency.
During the procedure, a strong surgical suture (stitch) is placed around the upper part of the cervix, at the level where the cervix meets the uterus (the cervico-isthmic junction). This stitch provides mechanical support to keep the cervix closed during pregnancy.
The procedure is performed using laparoscopic (keyhole) surgery, where small incisions in the abdomen allow the surgeon to place the cerclage with specialised instruments and a camera.
The indications for Transabdominal Cerclage can vary, but it should be considered as an option in cases where:
– There is a consistent history of Cervical Insufficiency, i.e., cervical dilatation and subsequent fetal loss or premature delivery in the absence of uterine contractions.
– A Transvaginal Cerclage done in a previous pregnancy has failed.
– The cervix is short or very irregular, usually after surgical procedures such as trachelectomies or cone biopsies and/or previous transvaginal cerclages.
The surgical procedure
The surgery is performed under general anaesthesia.
Using laparoscopic instruments, Dr Dunn:
- Inserts a camera through a small incision in the abdomen
- Identifies the cervix and surrounding structures
- Places a strong suture around the upper cervix
- Secures the stitch to reinforce cervical support
The stitch remains in place for future pregnancies.
