Local injection of diluted vasopressin and aqua dissection at the time of modified Shirodkar cerclage: Description of a safe and efficient technique

Many modifications have been incorporated to original Shirodkar technique to make the procedure an easy one whilst maintaining its efficacy. Anecdotal evidence suggest that use of vasoconstrictors before dissecting bladder base during Shirodkar method could be helpful. We performed aqua dissection using diluted vasopressin during modified Shirodkar cerclage in selected patients who required modified Shirodkar method. Our experience shows that judicious use local injection of diluted vasopressin to perform aqua dissection during modified Shirodkar is a safe and efficacious method and would increase the overall quality of the technique by reducing the blood loss and enhancing plane of dissection.