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

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. (Fertil Steril (R) 2008;89:974-80. (c) 2008 by American Society for Reproductive Medicine.)