Laparoscopic Repair of Caesarean Scar Defect

Objective: Caesarean scar defect, or isthmocele, is a reservoir type pouch on the anterior wall of the uterine isthmus caused by inappropriate healing of the lower segment incision after caesarean section. The incidence of caesarean scar defects is reported to be as high as 84%, and is increasing due to the rising rates of caesarean sections worldwide. Caesarean scar defects may be asymptomatic, or cause a number of gynaecologic and obstetric sequealae, including abnormal bleeding, pelvic pain, infertility and ectopic scar pregnancy. There is no current consensus on the ideal treatment for caesarean scar defects, with most evidence being limited to case reports.