A New Laparoscopic Procedure for the Correction of Vaginal Vault Prolapse

Fedele, Luigi; Garsia, S; Bianchi, Stefano; Albiero, A.; Dorta, Milena

doi:10.1016/s0022-5347(01)63547-x

Cited by 12 publications

(3 citation statements)

References 9 publications

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“…Their mean follow-up was nearly 1 year, with three patients requiring reoperation: one for a thirddegree cystocele and two for recurrent stress incontinence. Fedele and coauthors 10 reported on their experience with 12 operations by the laparoscopic approach for posthysterectomy vaginal vault prolapse and reported no complications and no recurrence with a follow-up ranging from 9 to 28 months.…”

Section: Role In Urologic Practicementioning

confidence: 99%

Laparoscopic Sacrocolpopexy for the Correction of Vaginal Vault Prolapse

Sundaram

Venkatesh

Landman

et al. 2004

Journal of Endourology

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sacrocolpopexy for the correction of vaginal vault prolapse." Journal of Endourology.18,7. 620-623. (2004). http://digitalcommons.wustl.edu/open_access_pubs/3160 620 INTRODUCTION VAGINAL VAULT PROLAPSE is descent of the apex of the vagina below the introitus, turning the vagina inside out. Vaginal vault prolapse is uncommon in the United States, occurring in only 900 to 1200 women annually, and is estimated to develop in 0.2% to 1% of women who have undergone hysterectomy. 1 The goals of correcting vault prolapse are relief of symptoms, restoration of normal vaginal anatomic relations, and preservation of coital function. Abdominal sacrocolpopexy, by suspending a mesh hammock between the prolapsed vaginal vault and sacrum, provides durable support to the vagina that has prolapsed after hysterectomy. [2][3][4] The laparoscopic approach to sacrocolpopexy for vaginal vault prolapse is a relatively new procedure, carried out in very few specialized centers across the country. We demonstrate our technique for this procedure and review the outcome. TECHNIQUEThe laparoscopic sacrocolpopexy was performed with the intent of applying the principles of open sacrocolpopexy. Laparoscopic techniques and instruments were adapted to duplicate open surgery. Our procedures were performed by an experienced laparoscopic surgeon (CPS) assisted by an experienced open surgeon (CGK). The equipment used is listed in Table 1. Patient preparationThe patient is placed in the dorsal lithotomy position, and the vagina and the abdomen are prepared and draped in a sterile fashion. The vagina, including the apex, is thoroughly prepared with povidone-iodine solution. The bladder is drained with a Foley catheter. Preoperatively, intravenous cefazolin and gentamicin are administered.

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Section: Role In Urologic Practicementioning

confidence: 99%

Laparoscopic Sacrocolpopexy for the Correction of Vaginal Vault Prolapse

Sundaram

Venkatesh

Landman

et al. 2004

Journal of Endourology

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“…These include the high posterior repair, colpocleisis, culdoplasty procedures (such as Moschowitz, Halban and McCall), sacro‐spinous fixation, sacro‐colpopexy and posterior intravaginal slingoplasty. Laparoscopically, several operations for prolapse have been reported, notably ventrosuspension, 18 cervicopexy, 19 suspension of the vault to rectus fascia, 20 high McCall, 21 sacro‐spinous fixation, 21 sacro‐colpopexy 22 and laparoscopic suture hysteropexy 23 . Currently there are three widely established and accepted surgical approaches adopted for the treatment of vault prolapse: sacro‐colpopexy, sacro‐spinous fixation and the posterior intravaginal slingoplasty.…”

Section: Treatmentmentioning

confidence: 99%

The vaginal vault

Cutner

Elneil

2004

BJOG

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“…This minimally invasive surgery involves, just as in open surgery, the placement of two prosthetic meshes to restore and confer adequate reinforcement of the pelvic tissues. 7 8 …”

Section: Introductionmentioning

confidence: 99%

A Study on Laparoscopic Sacral Colpopexy for Uterine Prolapse

Cho

Kim

et al. 2017

J Menopausal Med

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ObjectivesWe sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy and evaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse.MethodsNinety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016 at Chosun University Hospital. Patients' electronic medical records were investigated for demographic, intraoperative, and postoperative data. Strict definitions were used for all clinically relevant adverse events. Patients' outcomes were documented with 1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primary analysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groups as n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for all continuous variables.ResultsTheir mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaire and physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, two of transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgical results, while none complained of sexual dysfunction or problems performing her usual activities.ConclusionsLaparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results with complication rates similar to those of open surgery with the added benefit of being minimally invasive.

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A New Laparoscopic Procedure for the Correction of Vaginal Vault Prolapse

Abstract: If these results are confirmed in larger series with a longer followup, our laparoscopic approach would be considered a valid alternative to current surgical techniques.

Cited by 12 publications

References 9 publications

Laparoscopic Sacrocolpopexy for the Correction of Vaginal Vault Prolapse

Laparoscopic Sacrocolpopexy for the Correction of Vaginal Vault Prolapse

The vaginal vault

A Study on Laparoscopic Sacral Colpopexy for Uterine Prolapse

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