Less is more—a minimal approach technique for Cesarean Section

Background: The various techniques for performing a Cesarean Section (CS) have a long history. There are numerous surgical variations based on personal or local tradition, but these are not based on evidence and often have different outcomes on maternal and newborn health. Many modifications of the...

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Main Authors: Dragan Belci, Gian Carlo Di Renzo, Davor Zoričić, Andrea Tinelli, Antonio Malvasi, Michael Stark
Format: Article
Language:English
Published: IMR Press 2021-06-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/48/3/10.31083/j.ceog.2021.03.2422
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author Dragan Belci
Gian Carlo Di Renzo
Davor Zoričić
Andrea Tinelli
Antonio Malvasi
Michael Stark
author_facet Dragan Belci
Gian Carlo Di Renzo
Davor Zoričić
Andrea Tinelli
Antonio Malvasi
Michael Stark
author_sort Dragan Belci
collection DOAJ
description Background: The various techniques for performing a Cesarean Section (CS) have a long history. There are numerous surgical variations based on personal or local tradition, but these are not based on evidence and often have different outcomes on maternal and newborn health. Many modifications of the CS technique have been utilized in order to improve outcome with variable results both positive and negative. Several CS laparotomic methods have been developed but no consensus has been reached on the most optimal approach as related to safety and morbidity. Methods: The minimalistic approach of the Stark Cesarean Section (SCS) is compared to other methods thorugh an evaluation of the studies published in the last 20 years comparing this technique with others, the systematic reviews and the personal experience of the authors. Results and discussion: The abdominal incision done at the Stark Cesarean Section differs from the Pfannenstiel incision by its location being above the arcuate line eliminating the need to separate the fascia from the recti muscles. The muscle separations being away from the pubic bone and the iliohypogastric and ilioinguinal nerves eliminates the risk of damage. This unique surgical approach is a logical, fast and simple one that eliminates unnecessary operative steps saving time and reducing complications. After fifteen years of experience and thousands of SCS performed at our departments, we may conclude that this method has several advantages over other surgical methods as related to short and long-term outcomes, including chronic/neuropathic pain and quality of life.
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spelling doaj-art-261ea33a6d4149258be3a6cb9242d45e2025-08-20T03:48:35ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-06-0148347848210.31083/j.ceog.2021.03.24221623831638241-403197932Less is more—a minimal approach technique for Cesarean SectionDragan Belci0Gian Carlo Di Renzo1Davor Zoričić2Andrea Tinelli3Antonio Malvasi4Michael Stark5Department of Gynaecology and Obstetrics, General Hospital Pula, 52100 Pula, CroatiaThe New European Surgical Academy (NESA), 10117 Berlin, GermanyDepartment of Gynaecology and Obstetrics, General Hospital Pula, 52100 Pula, CroatiaDivision of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, 73100 Lecce, ItalyDepartment of Obstetrics and Gynecology, “Santa Maria” Hospital, G,V,M, Care & Research, 70124 Bari, ItalyThe New European Surgical Academy (NESA), 10117 Berlin, GermanyBackground: The various techniques for performing a Cesarean Section (CS) have a long history. There are numerous surgical variations based on personal or local tradition, but these are not based on evidence and often have different outcomes on maternal and newborn health. Many modifications of the CS technique have been utilized in order to improve outcome with variable results both positive and negative. Several CS laparotomic methods have been developed but no consensus has been reached on the most optimal approach as related to safety and morbidity. Methods: The minimalistic approach of the Stark Cesarean Section (SCS) is compared to other methods thorugh an evaluation of the studies published in the last 20 years comparing this technique with others, the systematic reviews and the personal experience of the authors. Results and discussion: The abdominal incision done at the Stark Cesarean Section differs from the Pfannenstiel incision by its location being above the arcuate line eliminating the need to separate the fascia from the recti muscles. The muscle separations being away from the pubic bone and the iliohypogastric and ilioinguinal nerves eliminates the risk of damage. This unique surgical approach is a logical, fast and simple one that eliminates unnecessary operative steps saving time and reducing complications. After fifteen years of experience and thousands of SCS performed at our departments, we may conclude that this method has several advantages over other surgical methods as related to short and long-term outcomes, including chronic/neuropathic pain and quality of life.https://www.imrpress.com/journal/CEOG/48/3/10.31083/j.ceog.2021.03.2422misgav ladach cesareanstark cesarean section (scs)techniques of cesarean sectionchronic pain
spellingShingle Dragan Belci
Gian Carlo Di Renzo
Davor Zoričić
Andrea Tinelli
Antonio Malvasi
Michael Stark
Less is more—a minimal approach technique for Cesarean Section
Clinical and Experimental Obstetrics & Gynecology
misgav ladach cesarean
stark cesarean section (scs)
techniques of cesarean section
chronic pain
title Less is more—a minimal approach technique for Cesarean Section
title_full Less is more—a minimal approach technique for Cesarean Section
title_fullStr Less is more—a minimal approach technique for Cesarean Section
title_full_unstemmed Less is more—a minimal approach technique for Cesarean Section
title_short Less is more—a minimal approach technique for Cesarean Section
title_sort less is more a minimal approach technique for cesarean section
topic misgav ladach cesarean
stark cesarean section (scs)
techniques of cesarean section
chronic pain
url https://www.imrpress.com/journal/CEOG/48/3/10.31083/j.ceog.2021.03.2422
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