C-section scar (niche) repair

Advanced Robotic Repair for C-Section Scar Defects (Niche)

For many women, the journey after a caesarean section involves frustrating and disruptive gynaecological symptoms that can go unexplained for years. If you experience persistent spotting long after your period has ended, chronic pelvic pain, or challenges with fertility, you may be dealing with a C-section scar defect, also known as a “niche” or isthmocele.

At Happiher, we specialize in identifying and treating this common yet often undiagnosed condition. Dr. Manou Kaur is a leading expert in advanced, minimally invasive robotic surgery designed to repair these defects, restore uterine integrity, and help you regain control of your gynaecological health.

Understanding a C-Section Niche (Isthmocoele)

A C-section niche is a small pouch or indentation that forms on the inside wall of the uterus at the site of a previous C-section incision. During the healing process, the uterine muscle may not fully close, creating a pocket.

This pouch can trap menstrual blood, which then slowly leaks out long after your period has finished. This can lead to a range of symptoms, including:

• Prolonged, brown, or irregular spotting after your period.
• Pain during menstruation or ovulation.
• Chronic pelvic pain.
• Secondary infertility, as the fluid in the niche can create an inhospitable environment for an embryo to implant.

The Solution: Precise, Restorative Robotic Surgery

The definitive treatment for a symptomatic C-section niche is surgical repair. Dr. Kaur utilizes the da Vinci robotic-assisted surgical system—the gold standard for this type of delicate, restorative procedure.

This minimally invasive approach allows for:

• Enhanced 3D Vision: Providing a highly detailed view of the uterine wall and scar tissue.
• Unmatched Precision: The robotic instruments allow for incredibly fine movements, enabling Dr. Kaur to meticulously excise the scar tissue from the niche and carefully suture the healthy uterine muscle together in multiple strong layers.
• Minimal Scarring: The procedure is performed through a few tiny incisions in the abdomen, resulting in significantly less pain and scarring than a traditional open surgery.

The goal of the surgery is to completely restore the smooth contour of the uterine wall, eliminating the pouch and resolving the associated symptoms.

Your Patient Journey: What to Expect

We are committed to providing a clear and supportive path from diagnosis to recovery.

1. Advanced Diagnostics: Your journey begins with a detailed consultation. A C-section niche is best diagnosed using advanced imaging, typically a transvaginal ultrasound or sometimes a diagnostic hysteroscopy, to precisely measure the defect and assess the surrounding uterine tissue.
2. Personalised Surgical Planning: Dr. Kaur will review your imaging with you and discuss the best surgical approach for your specific anatomy and future fertility goals.
3. The Robotic Repair Procedure: Performed under general anaesthesia, the surgery involves carefully removing the unhealthy scar tissue and reconstructing the uterine wall with precision. This keyhole procedure is typically completed within one to two hours.
4. A Faster Recovery: Thanks to the minimally invasive nature of robotic surgery, most patients require only an overnight stay in the hospital. Recovery is significantly faster and less painful than with a traditional abdominal surgery, allowing you to return to your normal activities much sooner.

Frequently Asked Questions (FAQ)

1. How long does it take to recover from the surgery?
   Most women feel significantly better within 1 to 2 weeks. We recommend avoiding strenuous activity and heavy lifting for about 4-6 weeks to ensure the uterine wall heals completely.
2. Can this procedure help me get pregnant?
   For women experiencing secondary infertility due to a C-section niche, surgical repair can significantly improve the chances of successful conception and a healthy pregnancy by creating a smooth, healthy uterine lining for embryo implantation.
3. Is this considered major surgery?
   While it is a definitive surgical procedure, it is performed in a minimally invasive manner. The use of robotics makes it a highly controlled, low-impact surgery with a much faster recovery profile than open surgery.
4. When can I try to conceive after the repair?
   Dr. Kaur typically recommends waiting about 3 months after the procedure before trying to conceive to allow the uterus to fully heal and strengthen.

Take the First Step Towards a Solution

If you are struggling with unexplained symptoms after a C-section, you don’t have to simply endure them. A solution may be closer than you think.