Abstract
The purpose of this video is to present a lateral to anterior approach to the scarred bladder flap and anterior abdominal wall adhesions. The increase in cesarean section rate has made this surgical scenario more prevalent. We will present videos from two separate case. Both patient has 2 previous cesarean sections, suspected adenomyosis, and had failed medical management. We will demonstrate an anatomic based technique where the paravesicle spaces are developed bilaterally. The bladder is then backfilled and the adhesions over the supravaginal septum are transected. The vesicouterine ligaments are then transected at their origin at the pericervical ring. This allows the vesicovaginal space to be developed.
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