Objective: To demonstrate a novel technique used to restore cervical patency in a patient with severe iatrogenic cervical stenosis.
Design: Surgical video case report.
Setting: A single academic institution.
Patient(s): We highlight the case of a 35-year-old nulliparous woman with a history of primary infertility. Her past medical history was significant for focal, invasive, well-differentiated squamous cell carcinoma of the cervix, for which she underwent a loop electrosurgical excision procedure. During her infertility assessment, she was found to have an extremely stenotic cervix that was refractory to conventional treatment options.
Interventions: This video highlights our innovative laparoscopic transfundal technique used to restore her cervical patency.
Main Outcome Measures: None, as this is a descriptive case report.
Results: Postoperatively, the patient had continued cervical patency for >1 year with successful fertility treatment resulting in pregnancy.
Conclusions: To our knowledge, this is the first case report describing a laparoscopic transfundal approach used to reestablish cervical patency. This approach may be considered for patients with cervical stenosis who have not responded to standard conservative therapies.
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| http://dx.doi.org/10.1016/j.fertnstert.2024.02.005 | DOI Listing |
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Laparoscopic transfundal approach to cervical dilation: a novel treatment for cervical stenosis and cervical factor infertility.
Fertil Steril
May 2024
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:
Objective: To demonstrate a novel technique used to restore cervical patency in a patient with severe iatrogenic cervical stenosis.
Design: Surgical video case report.
Setting: A single academic institution.
Transfundal insertion of a Veress needle in laparoscopy of obese subjects: a practical alternative.
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September 1999
Department of Obstetrics and Gynaecology, University of Oulu, FIN-90220 Oulu, Finland.
Because induction of artificial pneumoperitoneum through the infra-umbilical route is associated with complications in laparoscopic procedures, especially in obese patients, we performed a prospective randomized study comparing the conventional infra-umbilical route with a transfundal route, in which the Veress needle is inserted into the peritoneal cavity through the uterine fundus. One hundred obese subjects (body mass index >/=25 kg/m(2)) scheduled for laparoscopic sterilization were randomized into two groups. In the infra-umbilical group pneumoperitoneum was achieved at a ratio (punctures/pneumoperitoneum) of 56/49 (1.
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Sydney Women's Endosurgery Centre, St. George Private Hospital, Kogarah, NSW.
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View Article and Find Full Text PDFUltrasound-guided transfundal uterine sperm recovery from Macaca fascicularis.
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California Primate Research Center, University of California, Davis 95616.
Previous studies from this center have indicated that the cynomolgus macaque (Macaca fascicularis) may serve as a model for human sperm interaction with the cervix and uterus. In some macaque species, transcervical aspiration of the uterine contents carries a significant risk of disturbing the cervical milieu due to the serpentine nature of the cervix. The only alternatives have been surgical procedures such as laparotomy or laparoscopy.
View Article and Find Full Text PDFOne of the most troublesome features of laparoscopy is the establishment of pneumoperitoneum. This report discusses a very simple and direct way of establishing pneumoperitoneum via transfundal puncture.
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