Table 1

Main differences of our approach from the most cited conservative surgery techniques

Surgical step	Our approach	One-step conservative surgery6 9 12	Triple-P technique5	Stepwise surgical approach10
Pelvic devasularisation	Bilateral ligation of uterine arteries at low and high levels. Then, anterior and posterior cervical wall control sutures	Tied a knot, compressed or inflated a balloon inserted into the aorta, in case of severe adhesions or haemorrhage Placed two clamps on uterine branch of ovarian artery, then ligated both uterine arteries and cervical arteries	Inflation of pre-placed occlusion balloons in internal iliac arteries, with the interventional radiology service guidance	Bilateral internal iliac artery ligation
Myometrial repair	Myometrial reconstruction in two layers	Myometrial traction points sutures to test myometrial tensile capacity Incision repair by myometrial pulley sutures Uterine incision reinforcement by fibrin glue then polygalactin mesh fixed to uterine wall UB muscle wall reinforcement with 3.0 sutures	Compression sutures applied to the line of trophoblastic invasion into the UB, followed by uterine incision repair in two layers	Continuous mattress sutures, at 5 mm distance, everting the uterine edge to outside and including reflected peritoneum of UB with the lower uterine segment
Dealing with placenta in case of percreta invasiveness	Dissected from the UB after neoformed vessels devascularisation. UB injury may happen, and is repaired	Dissected from the UB after neoformed vessels devascularisation. UB injury may happen, and is repaired	This portion of the invading placenta is left in situ and followed-up	Dissected from the UB after neoformed vessels devascularisation. UB injury or cystectomy may happen, and are repaired

UB, urinary bladder.