Robotic-Assisted Laparoscopic Abdominal Cerclage Placement During Pregnancy

Study Objective: The objective of this study is to report our center's series of robotic-assisted laparoscopic abdominal cerclage (RALAC) placement during pregnancy. Design: Descriptive study (Canadian Task Force classification III). Setting: Single academic institution. Patients: Patients undergoing RALAC placement during pregnancy. Interventions: Eleven patients underwent RALAC. Measurements and Main Results: Nine out of 11 (81.8%) primary RALAC procedures resulted in a viable live-born neonate: 8 (72.7%) were born at >34 weeks of gestation. Three patients (27.3%) had preterm premature rupture of membranes on postoperative day one, 2 of whom subsequently underwent a dilation and curettage, and 1 patient carried the pregnancy to 29 weeks and delivered a live-born neonate. Four patients had subsequent pregnancies after placement of a RALAC in the antepartum period, all of whom carried successfully beyond 36 weeks, for a total of 16 pregnancies. Fourteen pregnancies (875%) resulted in a live birth, and 13 pregnancies (81.3%) were delivered beyond 34 weeks. Conclusion: RALAC is a minimally invasive procedure with an acceptable risk profile and comparable efficacy to traditional open abdominal cerclage. RALAC may be considered an acceptable alternative to open abdominal cerclage in pregnancy, and may be a particularly favorable option in certain settings. (C) 2017 AAGL. All rights reserved.