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.