Caesarean section according to Misgav Ladach

Research Article


Abstract views: 345 / PDF downloads: 127

Authors

  • Felis S

DOI:

https://doi.org/10.58372/2835-6276.1056

Keywords:

Caesarean, Misgav, Ladach

Abstract

The Misgav Ladach method for cesarean section is based on the principles of surgical minimalism. This is based on the Joel Cohen laparotomy, somewhat higher than the Pfannenstiel incision. Subcutaneous tissue is left undisturbed apart from the midline, rectus muscles are separated by pulling. The peritoneum is opened by stretching with index fingers. The hysterotomy is closed with one layer extraendometrial continuous absorbable stitches (Vicryl), and the visceral and parietal peritoneal layers are left open. Fascia is stitched with a continuous synthetic absorbable stitch. The skin is closed with intracutaneous resorptive suture or metallic stapler sutures. The Misgav Ladach method is restrictive in the use of sharp instruments preferring manual manipulation: it gives faster recovery, shorter period to normal bowel function, less peritoneal adhesions and less scarring in the abdominal layers, less use of postoperative antibiotics, analgesics and antipyretics, and a shorter anesthetic and operative time. It is ideal for emergency and planned cesarean section.

References

Joel-Cohen S. Abdominal and Vaginal Hysterectomy: New Techniques Based on Time and Motion Studies. London: William Heinemann Medical Books, 1972.

Joel-Cohen S. Abdominal and Vaginal Hysterectomy. 2nd Ed. Philadelphia: JB Lippincott, 1977.

Stark M, Finkel AR. Comparison between the JoelCohen and Pfannenstiel incisions in cesarean section. Eur J Obstet Gynecol Reprod Biol 1994; 53(2): 121–2.

Stark M, Chavkin Y, Kupfersztain C, Guedj P, Finkel AR. Evaluation of combinations of procedures in cesarean section. Int J Gynaecol Obstet 1995; 48(3): 273–6.

Holmgren G, Sjoholm L, Stark M. The Misgav Ladach method for cesarean section, method description. Acta Obstet Gynecol Scand 1999; 78(7): 615–21.

Mathai M, Hofmeyr GJ, Mathai NE. Abdominal surgical incisions for caesarean section. Cochrane Database Syst Rev 2013 31; 5: CD004453.

Malvasi A, Tinelli A, Farine D, Rahimi S, Cavallotti C, Vergara D, et al. Effects of visceral peritoneal closure on scar formation at cesarean delivery. Int J Gynaecol Obstet 2009; 105(2): 131–5.

Malvasi A, Tinelli A, Guido M, Cavallotti C, Dell’Edera D, Zizza A, et al. Effect of avoiding bladder flap formation in caesarean section on repeat caesarean delivery. Eur J Obstet Gynecol Reprod Biol 2011; 159(2): 300–4.

Hofmeyr GJ, Mathai M, Shah A, Novikova N. Techniques for caesarean section. Cochrane Database Syst Rev 2008; 23: CD004662.

Dodd JM, Anderson ER, Gates S. Surgical techniques for uterine incision and uterine closure at the time of caesarean section. Cochrane Database Syst Rev 2008; 23: CD004732.

CAESAR Study Collaborative Group. Caesarean section surgical techniques: A randomised factorial trial (CAESAR). BJOG 2010; 117(11): 1366–76.

CORONIS Collaborative Group. Caesarean section surgical techniques (CORONIS): A fractional, factorial, unmasked, randomised controlled trial. Lancet 2013; 382(9888): 234–48.

Ezechi O, Ezeobi P, Gab-Okafor C, Edet A, Nwokoro C, Akinlade A. Maternal and fetal effect of Misgav Ladach cesarean section in Nigerian women: A randomized control study. Ann Med Health Sci Res 2013; 3(4): 577–82.

Abuelghar WM, El-Bishry G, Emam LH. Caesarean deliveries by Pfannenstiel versus Joel-Cohen incision: A randomised controlled trial. J Turk Ger Gynecol Assoc 2013; 14(4): 194–200.

Bolze PA, Massoud M, Gaucherand P, Doret M. What about the Misgav-Ladach surgical technique in patients with previous cesarean sections? Am J Perinatol 2013; 30(3): 197–200.

Heimann J, Hitschold T, Muller K, Berle P. Modifizierte Misgav-Ladach-Technik der Sectio caesarea im Vergleich mit einer konventionellen PfannenstielTechnik: Eine prospektiv-randomisierte Studie an 240 Patientinnen eines Perinatalzentrums [Randomized trial of the modified Misgav-Ladach and the conventional Pfannenstiel techniques for cesarean section]. Geburtshilfe Frauenheilkd 2000; 60(5): 242–50.

Franchi M, Ghezzi F, Balestreri D, Beretta P, Maymon E, Miglierina M, et al. A randomized clinical trial of two surgical techniques for cesarean section. Am J Perinatol 1998; 15(10): 589–94.

Franchi M, Ghezzi F, Raio L, Di Naro E, Miglierina M, Agosti M, et al. Joel-Cohen or Pfannenstiel incision at cesarean delivery: Does it make a difference? Acta Obstet Gynecol Scand 2002; 81(11): 1040–6.

Li M, Zou L, Zhu J. Study on modification of the Misgav Ladach method for cesarean section. J Tongji Med Uni 2001; 21(1): 75–7.

Koettnitz F, Feldkamp E, Werner C. ‘Die sanfte Sektio’: Eine Variante der Cohen-Methode im Vergleich zum klassischen Pfannenstielschnitt [‘The gentle caesarean’: A variant of the Cohen method compared to the classical Pfannenstiel]. Zentralbl Gynakol 1999; 121(6): 287–9.

Xavier P, Ayres-De-Campos D, Reynolds A, Guimaraes M, Costa-Santos C, Patricio B. The modified Misgav-Ladach versus the Pfannenstiel–Kerr technique for cesarean section: A randomized trial. Acta Obstet Gynecol Scand 2005; 84(9): 878–82.

Stark M. Optimised meta-analysis should be based on standardised methods. BJOG 2011; 118(6): 765–6

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Published

2023-08-06

How to Cite

S, F. (2023). Caesarean section according to Misgav Ladach: Research Article. American Journal of Medical and Clinical Research & Reviews, 2(8), 1–9. https://doi.org/10.58372/2835-6276.1056

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