How a Robot-assisted Surgery at Baptist Memorial Hospital Helps Prevent Miscarriage

Procedure Helps High-risk Pregnant Women Deliver Full-term Babies

Until recently, it was not uncommon for some women in the Mid-South to travel as far as Chicago for a procedure to help prevent miscarriages and preterm deliveries. Now, local oncologists who practice at Baptist Memorial Hospital for Women are offering the leading-edge procedure—called robotic-assisted cervical cerclage. During a cervical cerclage, doctors place a single stitch around the cervix to stop it from opening too early during pregnancy. According to the American Pregnancy Association, less than 1 percent of pregnant women need a cervical cerclage. “Women at risk for these complications have a weakened or short cervix,” said Dr. Sanjeev Kumar, gynecologic oncologist with Baptist Cancer Center. Using robotic technology, Kumar inserts the cervical stitch to increase women’s chances of delivering healthy, full-term babies.

What is robot-assisted cervical cerclage?

Several second trimester miscarriages happen because the cervix opens too early. While doctors can evaluate patients for an incompetent cervix before pregnancy, the condition is usually not diagnosed until a patient experiences a second or third trimester miscarriage. According to Kumar, cervical cerclage can be done vaginally, abdominally or robotically. “In highly selected patients, our first approach is to do the procedure vaginally because it's a smaller operation,” said Kumar. “If the vaginal stitch fails, then we recommend an abdominal or robotic cerclage.” Robotic cerclage uses the da Vinci Surgical System and requires only a few small abdominal incisions. Doctors rely on 3D images to view the surgical field and minimize their movements in real time. With robot-assisted cerclage, Kumar can take careful measures to avoid blood vessels, hence reducing the risk for errors and injuries. “The stitch is left in for good, unless it's removed at the time of cesarean section,” said Kumar.

Risks and Benefits of Cervical Cerclage

“Just like any surgery, there are some risks involved,” said Kumar. “Risks include pain, infection, bleeding, damage to internal organs and a very rare chance of death. If the patient is pregnant, there is some risk of pregnancy loss as well. But those risks are extremely low, and they are lower with the robotic approach. Most patients who have this operation go home just fine.” Typically, patients go home the same day after surgery. Within one to two weeks, most patients report a complete recovery. However, as they recover at home, patients should watch for nausea, vomiting, fever, chills, excessive bleeding and contractions of the uterus. “If any of those things are going on, please call us,” said Kumar. “We can make sure our health care team sees you and takes the appropriate next steps.” For cervical cerclage patient Andranika Arnett, the main benefit of the procedure—preventing preterm births—outweighed possible risks and gave her hope for finally starting a family. “It was a relief,” said Arnett. “I thought it was the end—that I wasn’t going to be able to try for a child again.” In addition to helping women start families of their own, robotic-assisted cervical cerclage is a minimally invasive option resulting in less pain, less scarring and less trauma to muscles and nerves. “Especially if you’re older or overweight and your doctor recommends abdominal cervical cerclage, discuss the robotic approach with him or her,” said Kumar. “This method is going to decrease your risk of infection and lessen pain during recovery. The robotic approach to the operation will be safer overall.”

Choosing Cervical Cerclage at Baptist

Kumar and Baptist’s health care team are passionate about helping patients understand the risks, benefits and team approach they take to robotic cervical cerclage. Patients know what to expect before, during and after surgery. “At our clinic, patients fast after midnight to prepare for the procedure,” said Kumar. “On the day of the operation, the surgery itself lasts 30 to 40 minutes—and patients typically go home that day. Previously, our patients traveled as far as Chicago for this operation, but I want them to know that we are doing these operations now at Baptist. They should not have to travel out of town because we can do it right here in Memphis.” Watch the WMC news story to learn more about robotic-assisted cervical cerclage or explore maternity programs and the high-risk delivery referral program at Baptist Memorial Hospital for Women. Find a doctor by visiting our Find a Physician page.