December 13, 2017

C-section

Minimally Invasive C-section

Over the past several decades, C-sections have become safer for mothers. This is mostly because of safer anesthesia methods, but also because of evolving surgical techniques.

Smaller incision
C-sections used to be done using a large vertical incision, and only as an absolute emergency. This led to an emergency operation with emergency anesthesia, and emergency surgical techniques.

Over the past several decades, we have learned that in a controlled situation, C-sections can be done in a minimally invasive way.

Incision size
The typical C-section incision is 8-9 inches long. Larger incisions are associated with more pain and longer healing times, as well as more visible scarring.

Through minimally invasive techniques, Dr. Maikis typically makes an incision that is 4-6 inches long. This leads to less blood loss, faster healing and recovery, and less scarring.

Abdominal muscles
During normal pregnancy, the vertical abdominal muscles in most women will slowly separate down the center of the abdomen to accommodate the growing baby. After the baby is delivered, those muscles will only go back together by either a plastic surgery operation, or by repair during a C-section. The minimally invasive C-section not only does not cut these abdominal muscles, but the muscles are repaired after the baby is delivered. This restores the vertical abdominal muscles to their normal position, and the abdominal wall looks more like it did prior to pregnancy.

Less blood loss
The uterus in a non-pregnant woman typically gets about 7% of the body’s blood flow. In a pregnant woman close to delivery, the uterus gets 25-30% of the body’s blood flow. To do a C-section, an incision is made into the uterine muscle to deliver the baby. This incision opens up many blood vessels, and can lead to a large amount of blood loss in a short amount of time.

The minimally invasive technique makes a smaller uterine incision so the amount of blood loss is less. Dr. Maikis also uses special clamps on both sides of the incision during repair of the uterus to temporarily close the blood vessels. This minimizes the amount of blood loss as the uterine incision is closed. This also minimizes the anemia that is typical after a C-section, and leads to a more energetic new mom.

Safety for mother and baby
Minimally invasive C-section is clearly safer for the mother. This is because of a smaller incision leading to less blood loss, less pain, quicker recovery and quicker time to normal activity. It is also safer for baby. The smaller incision more closely mimics the enclosed journey down the birth canal. There is evidence that this enclosed passage improves immediate infant lung function, allowing the baby to make an easier transition into the world.