Misgav Ladach technique is superior to conventional caesarean section - Lessening of the patients' burden and equal incidence of complications

Postoperative recovery following Caesarean section reduces the mother's abi lity to care for her newborn. Efforts to lessen postoperative disability fa cilitate the mother's competence and decrease costs. A new operative techni que for Caesarean section was suggested at Misgav-Ladach (ML) Hospital in J erusalem. By favouring a less disruptive opening of the abdominal wall and minimising the procedures for abdominal closing, this technique enables les s tissue trauma resulting in accelerated recovery. To test this hypothesis we evaluated the postoperative course of patients with elective Caesarean s ection at term between October 1996 and October 1997. Material and Methods: After a training-period for Mt-section, the choice of technique was due to the surgeons' prevalence. All Caesarean sections were performed by well-trained, experienced obstetricians. Patients were divide d into 2 groups according to operative technique: The Mt-group consisted of 112 patients, the conventional group of 114 patients. Mt section was perfo rmed as described by Stark et al. [10], conventional technique included Pfa nnenstiel incisions, opening of the vesicouterine plica and slight dislocat ion of the uterine bladder, separate closure of uterine muscle and uterine peritoneum, closure of parietal peritoneum, fascia and skin by sutures and subfascial drainage. Results: The modified technique compared to the standard technique, resulte d in shorter operative time (28.9+/-7.1 vs. 41.6 +/- 10.2 min; p < 0.005) a nd a reduced postoperative hospital stay (7.8 +/- 2.0 vs. 8.4+/- 2.4 d; p < 0.05). There was no difference between the two groups with regard to blood loss (difference in pre- and postoperative blood count), incidence of post operative fever OF haematoma. Conclusion: The Misgav Ladach Caesarean section is a safe procedure and red uces operation time and hospital stay. As a result of this short-term obser vation Mt technique seems superior; however, this study has to be completed by long-term results including formation of postoperative adhesions.