Vasopressin vs. Uterine Artery Clamping for Laparoscopic Cesarean Scar Niche Repair

Noninferiority of Intramyometrial Vasopressin Injection Compared to Bilateral Temporary Clamping of Uterine Arteries During Laparoscopic Excision and Repair of Cesarean Scar Niche

This study evaluates two methods for controlling intraoperative bleeding during laparoscopic surgery to repair a cesarean scar niche (CSN). It compares the effectiveness of intramyometrial vasopressin injection against bilateral temporary clamping of the uterine arteries using laparoscopic bulldog clips. The goal is to determine if vasopressin injection is non-inferior to arterial clamping in reducing blood loss and maintaining surgical field visibility.

Inclusion Criteria:

• Diagnosis of symptomatic CSN.
• Scheduled for laparoscopic excision and repair.

Exclusion Criteria:

• Contraindications to vasopressin (e.g., severe hypertension or cardiovascular disease).
• Presence of other major uterine pathologies (e.g., large myomas or malignancy).