Minimally invasive cesarean: Improving an innovative technique

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July 2004 · Vol. 16, No. 7

Minimally invasive cesarean:
Improving an innovative technique

Short operative time, less surgical dissection, and reduced risk of infection are among the advantages of this newly updated procedure.

MARCO A. PELOSI II, MD; MARCO A. PELOSI III, MD

Dr. Pelosi II is director and Dr. Pelosi III is associate director, Pelosi Women’s Medical Center, Bayonne, NJ. Dr. Pelosi II also serves on the OBG Management Board of Editors.

KEY POINTS

A simplified abdominal incision makes the traditional extensive dissection associated with the Pfannenstiel incision unnecessary.
A soft, self-retaining abdominal retractor offers increased exposure, atraumatic retraction, incision protection, and adjustable height while facilitating delivery of the fetal head by creating a rigid border around the abdominal incision.
Bladder-flap omission has been associated with reduced operative time and incision-delivery interval, decreased blood loss, and less need for postoperative analgesics.

Is the extensive dissection of the Pfannenstiel incision necessary in cesarean delivery? Is bladder dissection essential? Must the visceral and parietal peritoneum be closed?

The success of our minimally invasive cesarean technique suggests the answer is “no.”

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