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Transobturator vaginal tape in 10 steps

Mangano Erika, Campagne-Louise Sandrine, Curinier Sandra, Botchrosvili Revaz, Canis Michel, Chauvet Pauline, Bourdel Nicolas
Journal of Minimally Invasive Gynecology 2019 July 2

STUDY OBJECTIVE: Transvaginal Tension Free Vaginal Tape-Obturator (TVT-O) is an effective surgical treatment for stress urinary incontinence in women [1]. A correct preoperative urodynamic study has a role in obtaining best results. However some complications still occur during and after this surgical procedure. These complications cause a high burden for patients, who frequently have to receive others invasive treatments subsequently. The main objective of this video is the standardization and accurate description of this surgical procedure adding some tips and tricks.

DESIGN: Step-by-step description of the technique through a video. The local institutional review board was consulted and ruled that approval was not required for this video article because the 37 video describes a technique and does not report a clinical case. The patients cannot be identified and they signed a written consent to use of video recording for research/scientific/teaching purpose.

SETTING: A French tertiary care teaching hospital.

PATIENTS: We considered video recording of TVT-O procedures in the same French tertiary care teaching hospital.

INTERVENTION: We identify more delicate steps of this surgical procedure in order to give advices for managing them successfully. Moreover we assess 10 rational steps in the procedure, which can help to standardize it.

MEASUREMENTS AND MAIN RESULTS: This video presents clearly the standardization of this technique in 10 step: 1. Patient's ergonomy, 2. Anesthetic infiltration, 3. Single vaginal incision, 4. Creation of the pathway for device placement, 5. Placement of the device, 6. Check flat position of the tape, 7. Obtain right tension of the mesh, 8. Cut both lateral arms of the tape emerging from the skin, 9. Urinary drainage to exclude stenosis, 10. Suture vaginal mucosa and skin.

CONCLUSION: Together with an appropriate preoperative study, the standardization of this surgical procedure and the application of tips and tricks suggested could make this technique easier to learn for beginners [2] and could help experienced surgeons in reducing, as much as possible, the most frequent complications too [3].


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