{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:51:53Z","timestamp":1776905513905,"version":"3.51.2"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the anatomic, clinical, and reproductive outcomes of the K\u0131z\u0131ldemir VISTA (Vertical Isthmocele Surgical Transvaginal Approach), a novel continuous vertical suture technique for transvaginal isthmocele repair, also referred to as cesarean scar defect\u2010related disorder (CSDi).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective single\u2010arm pilot study, conducted at a university hospital, enrolled 21 women with symptomatic isthmocele (residual myometrial thickness [RMT] \u2264\u20093\u2009mm) and secondary infertility or recurrent pregnancy loss. All patients underwent transvaginal repair using a novel continuous vertical (craniocaudal) suture technique. The primary outcome was the change in RMT at 3\u2009months postoperatively. Secondary outcomes included symptom resolution (postmenstrual spotting, pelvic pain) and pregnancy rates at 12\u2010month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean RMT significantly increased from 1.5\u2009\u00b1\u20090.5\u2009mm preoperatively to 6.9\u2009\u00b1\u20091.8\u2009mm postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A corresponding significant reduction in niche depth was observed (7.1\u2009\u00b1\u20091.2\u2009mm to 2.1\u2009\u00b1\u20091.0\u2009mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Symptom resolution was high: postmenstrual spotting resolved in 14\/16 patients (87.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) and chronic pelvic pain resolved in 6\/7 patients (85.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). Among 20 patients desiring pregnancy, 14 (70%) conceived (57.1% spontaneous, 42.9% via ART), resulting in 11 live births and 3 ongoing pregnancies. Postoperative RMT was significantly higher in patients who conceived (7.3\u2009\u00b1\u20091.6\u2009mm) compared to those who did not (5.8\u2009\u00b1\u20091.2\u2009mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). No major complications or 12\u2010month recurrences were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The novel continuous vertical suture technique for transvaginal isthmocele repair appears to be a promising and feasible approach. Within this pilot cohort, it significantly restored myometrial integrity, effectively resolved associated symptoms, and was associated with favorable pregnancy rates, particularly in patients who achieved greater postoperative myometrial thickness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70279","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T01:10:51Z","timestamp":1776388251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The K\u0131z\u0131ldemir VISTA Technique (Vertical Isthmocele Surgical Transvaginal Approach): Prospective Analysis of Anatomic and Reproductive Outcomes of a Novel Vertical Suture Technique"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-8275","authenticated-orcid":false,"given":"Yusuf Ziya","family":"Kizildemir","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0840-5680","authenticated-orcid":false,"given":"Elif","family":"Deniz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8400-441X","authenticated-orcid":false,"given":"Mehmet","family":"Incebiyik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5369-3897","authenticated-orcid":false,"given":"Helin","family":"Kalir","sequence":"additional","affiliation":[{"name":"Department of Nursing, Institute of Health Sciences Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8343-6920","authenticated-orcid":false,"given":"Sezin Eda","family":"Karsli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u015eanl\u0131urfa Training and Research Hospital  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-6429","authenticated-orcid":false,"given":"I\u015f\u0131l I\u015f\u0131k","family":"Okuyan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u015eanl\u0131urfa Training and Research Hospital  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8729-1669","authenticated-orcid":false,"given":"Bekir","family":"Kahveci","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u015eanl\u0131urfa Training and Research Hospital  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7401-3945","authenticated-orcid":false,"given":"Sibel","family":"Sak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-1057","authenticated-orcid":false,"given":"Muhammed Erdal","family":"Sak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Harran University  \u015eanl\u0131urfa Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2021.0195"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1507482"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14134551"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13082192"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.70005"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13199"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05438-0"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2021.03.012"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.4274\/anajog.galenos.2024.96168"},{"issue":"2","key":"e_1_2_13_11_1","first-page":"280","article-title":"Arrangement of Muscle Fibers in the Myometrium of the Human Uterus: A Mesoscopic Study","volume":"4","author":"Escalante N. 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