JOURNAL ARTICLE

LESS sacrocolpopexy: step by step of a simplified knotless technique

Marcos Tobias-Machado, Felipe A Chicoli, Renato M M Costa, Alexandre Stievano Carlos, Carlos A Bezerra, Luiz F F Longuino, Eduardo S Starling, André L F Tome, Antonio C L Pompeo
International Braz J Urol: Official Journal of the Brazilian Society of Urology 2012, 38 (6): 859-60
23302408

INTRODUCTION: Pelvic organ prolapse is an ordinary disease with around 200.000 surgeries performed annually in the US to treat this condition. The surgical treatment for complete vaginal vault prolapse after hysterectomy involves abdominal or vaginal sacrocolpopexy. The purpose of this video is to demonstrate the steps of a laparoendoscopic single-site surgery (LESS) sacrocolpopexy performed by a simplified knotless technique.

MATERIALS AND METHODS: A 52 year-old female submitted a total hysterectomy five years ago due to miomatosis who developed vault prolapse and urinary incontinence after surgery. She was treated by transumbilical LESS cutaneous retractor and a surgical glove attached to three trocars through a 3.5 cm umbilical incision. Patient was positioned in lithotomy, the Y-shape polypropylene mesh was passed through the trocar. Only conventional laparoscopic instruments were used for intrabdominal dissection of vagina and peritoneum. The mesh was fixed to the vaginal fornix using 3 continuous sutures held in extremities by polymeric clips. The last helical suture was fixed by polymeric clips to the sacral periosteum from the promontory to achieve good vaginal positioning without tension. The posterior peritoneum was closed over the mesh.

RESULTS: The operative time was 150 minutes, blood loss of approximately 100 mL and the patient was discharged after 18 hours with no immediate complications and a 3 months follow-up free of vault prolapse and urinary incontinence until now.

CONCLUSIONS: LESS sacrocolpopexy performed with conventional instruments is feasible and a safe procedure reproducing surgical steps of conventional laparoscopic or robotic surgery.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23302408
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"