Surgical procedures
All surgical procedures were performed by an experienced surgeon as
previously described 12,
13, 16.
After administering continuous epidural anesthesia, patients were placed
in the bladder lithotomy position. The bladder was empty in all
patients. The anterior peritoneal reflection was opened, and the
abdominal cavity was entered. After exposing the lower uterine segment,
a probe was used to identify the CSD area. The tissue was trimmed with
scissors to reveal the healthy myometrium, and the CSD tissue was
completely removed. The myometrium was closed using a double-layer
closure of 1-0 absorbable sutures with an interrupted suture (Fig. S2).