The history of extra-peritoneal cesareans
Cesarean's etymology (cesaere: "to cut") and the first testimonies of such operations date from Antiquity. Extra-peritoneal cesarean began in the 19th century.
As early as 1823, Louis-Auguste Baudelocque described it in his thesis as a "new procedure for cesareans" with an extra-peritoneal approach. This concept was dictated by the observation of an extremely high maternal mortality rate related to cesareans at that time. Unfortunately, his thesis was rejected by his masters at the time, because two fields started to clash: "Cesareans" (those who practiced cesareans) and "symphisians" (those who cut the pubic symphysis); and at that time the symphisians prevailed.
Subsequently, different techniques for extra-peritonization of the uterine scar were described, with the same concern of avoiding contamination of the peritoneal cavity with infected amniotic fluid [Mokgokong, et al., 1974].
Two techniques were commonly used: the detachment of the bladder dome, with the risk of bladder wounds that this involved due to the intimate bladder closure there, or the intra-peritoneal opening to suture, over the hysterotomy, the parietal leaf with the visceral leaf of the peritoneum, thus extra-peritonizing the scar.
The advent of antibiotics and the relative technical complexity of the extra-peritoneal approach have had a negative impact on this type of cesarean section, which has retained very few indications. Short articles have been regularly published on the subject, and several authors have stressed the potential benefits of an extra-peritoneal cesarean in terms of post-operative comfort of the patients.
The technique described in 1996 by Denis Fauck and Jacques Henri Ravina is very different from all these other techniques, because it combines a large number of innovations in the approach and realization, does not require any new prostheses or drugs, and the latest scientific developments to allow for earlier autonomy.
In addition to the extra-peritoneal approach, the use of a vertical paramedic fascial incision, routinely used in vascular surgery for large pelvic bones and abdominal surgery, permits a quicker rehabilitation in the immediate postoperative period.
The absence of a urinary catheter and the respect of the main functions (immediate mobility, first normal meal, possibility of carrying the child immediately) allow patients to leave on the same day and make this ambulatory technique an interesting alternative to the classic technique. The average stay can thus be as short as that of a normal delivery, whereas for the intra-peritoneal cesarean, the average stay is 6 days. This explains the name chosen for this international technique: the "French AmbUlatory Cesarean Section" (FAUCS).