Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature

<i>Background and Objectives</i>: The isthmocele is a pouch-shaped defect in the anterior uterine wall, site of a previous cesarean section, due to a scar defect or dehiscence. The prevalence could be underestimated, but the rate of cesarean section is still high in the world. The prefer...

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Main Authors: Daniela Surico, Alessandro Vigone, Carlotta Monateri, Mario Tortora, Carmen Imma Aquino
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1123
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author Daniela Surico
Alessandro Vigone
Carlotta Monateri
Mario Tortora
Carmen Imma Aquino
author_facet Daniela Surico
Alessandro Vigone
Carlotta Monateri
Mario Tortora
Carmen Imma Aquino
author_sort Daniela Surico
collection DOAJ
description <i>Background and Objectives</i>: The isthmocele is a pouch-shaped defect in the anterior uterine wall, site of a previous cesarean section, due to a scar defect or dehiscence. The prevalence could be underestimated, but the rate of cesarean section is still high in the world. The preferable technique to correct this anomaly is not clearly indicated in the literature. Our objective is to evaluate the literature on the surgical treatment of isthmocele in pre-Cesarean women treated with minimally invasive technique. Our hypothesis is that robotic treatment is more effective than other procedures in women desirous of having children. <i>Materials and Methods</i>: The words “isthmocele”, “laparoscopy”, “robot” and “cesarean scar pregnancy” were searched on the main online scientific search sources (PubMed, Google Scholar, Scopus, WES, and Embase, etc.). We included articles in English and French, chosen for the relevance to the topic. We have decided to include also surgical corrections of isthmocele linked to pregnancies at the site of the defect, with particular attention to video training explanation. <i>Results</i>: We analyzed the literature about the minimally invasive surgery for the repair of an isthmocele, evaluating 20 articles. Comparing several surgical techniques, robotic-assisted laparoscopy could be an effective method to correct the defect, without high risk of intraoperative complications. <i>Conclusions</i>: As indicated in the literature, robotic tailored excision and repair of isthmocele (and of concomitant cesarean scar pregnancy) could be advantageous and safe, and it is necessary to promote video-training about this technique.
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spelling doaj-art-01ba8d166aee4b6a811f54a7490d29162025-08-20T03:58:27ZengMDPI AGMedicina1010-660X1648-91442025-06-01617112310.3390/medicina61071123Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the LiteratureDaniela Surico0Alessandro Vigone1Carlotta Monateri2Mario Tortora3Carmen Imma Aquino4Department of Translational Medicine, Università del Piemonte Orientale, Gynecology and Obstetrics, AOU “Maggiore della Carità”, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale, Gynecology and Obstetrics, AOU “Maggiore della Carità”, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale, Gynecology and Obstetrics, AOU “Maggiore della Carità”, 28100 Novara, ItalyNeuroradiology Unit, Department of Advanced Biomedical Sciences, Università “Federico II”, 80138 Naples, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale, Gynecology and Obstetrics, AOU “Maggiore della Carità”, 28100 Novara, Italy<i>Background and Objectives</i>: The isthmocele is a pouch-shaped defect in the anterior uterine wall, site of a previous cesarean section, due to a scar defect or dehiscence. The prevalence could be underestimated, but the rate of cesarean section is still high in the world. The preferable technique to correct this anomaly is not clearly indicated in the literature. Our objective is to evaluate the literature on the surgical treatment of isthmocele in pre-Cesarean women treated with minimally invasive technique. Our hypothesis is that robotic treatment is more effective than other procedures in women desirous of having children. <i>Materials and Methods</i>: The words “isthmocele”, “laparoscopy”, “robot” and “cesarean scar pregnancy” were searched on the main online scientific search sources (PubMed, Google Scholar, Scopus, WES, and Embase, etc.). We included articles in English and French, chosen for the relevance to the topic. We have decided to include also surgical corrections of isthmocele linked to pregnancies at the site of the defect, with particular attention to video training explanation. <i>Results</i>: We analyzed the literature about the minimally invasive surgery for the repair of an isthmocele, evaluating 20 articles. Comparing several surgical techniques, robotic-assisted laparoscopy could be an effective method to correct the defect, without high risk of intraoperative complications. <i>Conclusions</i>: As indicated in the literature, robotic tailored excision and repair of isthmocele (and of concomitant cesarean scar pregnancy) could be advantageous and safe, and it is necessary to promote video-training about this technique.https://www.mdpi.com/1648-9144/61/7/1123isthmocelecesarean scar defectcesarean section complicationscesarean scar pregnancylaparoscopyrobotic-assisted surgery
spellingShingle Daniela Surico
Alessandro Vigone
Carlotta Monateri
Mario Tortora
Carmen Imma Aquino
Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
Medicina
isthmocele
cesarean scar defect
cesarean section complications
cesarean scar pregnancy
laparoscopy
robotic-assisted surgery
title Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
title_full Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
title_fullStr Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
title_full_unstemmed Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
title_short Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
title_sort minimally invasive surgery for the excision and repair of cesarean scar defect a scoping review of the literature
topic isthmocele
cesarean scar defect
cesarean section complications
cesarean scar pregnancy
laparoscopy
robotic-assisted surgery
url https://www.mdpi.com/1648-9144/61/7/1123
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