Shirodkar’s operation /shir′odkärz″/ [N.V. Shirodkar, Indian obstetrician, 1900–1971] , a surgical procedure called a cerclage in which the cervical canal is closed by a purse-string suture embedded in the uterine cervix encircling the canal. It is performed to correct an incompetent cervix that has failed to retain previous pregnancies. Under spinal block or general anesthesia, a 5-mm–wide band of nonabsorbable material is buried beneath the mucosa of the cervix and pulled in a purse-string manner to close the cervix. The band may be left in place permanently, in which case subsequent deliveries are by cesarean section. Occasionally, a temporary cerclage is done, sewing in the band and leaving the ends exposed in the vagina. The band is then removed before labor and vaginal delivery. Postoperatively, infection or vaginal fistula may occur. If labor begins with the suture in place, the suture is removed promptly or the infant is delivered by cesarean section, before the uterus ruptures.
