Laparoscopic Isthmocele Repair

Inclusion Criteria: * The study will include women aged 18-45 years who present with symptomatic isthmocele. * Participants must have a residual myometrial thickness of less than 2.5 mm. * Participants must desire future fertility. Exclusion Criteria: Age below 18 or above 45 years Atypical endometrial cells or cervical dysplasia on cytology Asymptomatic isthmocele Candidacy for hysteroscopic surgery Cervical or pelvic infections Cervical dilation of 4 cm or more (emergency surgery) Conditions impairing tissue healing, such as: Type 1 or Type 2 diabetes mellitus Hematologic disorders associated with bleeding diathesis Contraindications for spinal or general anesthesia Continuous use of oral contraceptives (OCPs) or GnRH agonists that affect menstrual cycles Hydrosalpinx communicating with the uterine cavity Intrauterine device (IUD) in place Known connective tissue disorders Menstrual irregularities: Cycles longer than 35 days Cycle variations of 2 weeks or more Ongoing pregnancy Presence of structural abnormalities such as: Uterine or cervical polyps Submucosal fibroids Other similar conditions Residual myometrial thickness \> 2.5 mm Retained placental tissue Suspected malignancies Uterine anomalies Immunosuppressive diseases