Design: A retrospective study

Setting: A single tertiary university-affiliated medical center

Patients or Participants: All women following Robotic-Assisted Abdominal Cerclage placement during November 2020 to February 2024

Interventions: Data were collected from women's medical files including demographics, medical history, obstetrical and gynecological characteristics, indication for cerclage placement, operative and post-operative outcomes. Additionally, conception rate, pregnancy, and delivery characteristics were reviewed. The primary outcome was defined as the rate of delivery ≥32 weeks of gestation. Data are presented as mean and standard deviation.

Measurements and Main Results: Sixteen women underwent robotic-assisted abdominal cerclage during the study period, of whom 6 (37.5%) were pregnant during the procedure. The mean age of the women and body mass index were 34.4 (±4.4 SD) years-old and 35.7 (±6.9 SD) kg/m², respectively. The mean gravida was 3.8 (±1.8 SD) with a parity of 0.6 (±1.0 SD). Approximately 60% of the women had a history of previous vaginal cerclage (n=9). The mean gestational age of previous miscarriages was 21.5 (±4.6 SD). The mean surgical duration was 136 (±40) minutes with minimal blood loss [mean: 50 (±40 SD) cc]. Two of the procedures performed during pregnancy were converted, one to an open approach as the patient did not tolerate Trendelenburg and one to a vaginal approach due to substantial pelvic adhesions. Four of the seven women (70% of the non-pregnant) attempted to conceive, got pregnant with an average time of 3.1 (±3.3SD) months. Six of the women included in the study (36%) had already given birth with an average gestational age of 34.7 (±3.4SD).

Conclusion: Robotic-assisted abdominal cerclage is a feasible option for the treatment of cervical insufficiency with a low complication rate.