Abstract
Introduction and hypothesis
The use of mesh at the time of anterior vaginal wall repair reduced the risk of recurrent anterior vaginal wall prolapse. The aim of our video is to demonstrate our dissection technique focusing on the main anatomical landmarks in the pelvis and present an overall safer system to correct pelvic floor prolapse.
Methods
The video demonstrates correction of cystocele with the EndoFast Reliant™ system (IBI Israel Biomedical Innovations, Caesarea Industrial Park South, Israel). The surgical technique is described.
Results
Twenty-nine patients were treated with the system. Mean follow-up was 10 (range, 6–30) months. At latest follow-up, favorable anatomical results were obtained for 26 of 29 patients (89.6 %); three patients presented stage 1 nonsymptomatic prolapse. Three cases (13 %) of de novo stress urinary incontinence (SUI) and two cases of de novo urgency (6.9 %) were diagnosed and treated. Postoperative voiding difficulties, dyspareunia, or pain were not observed.
Conclusion
The operation with the trocarless system was found to be safe, easy to learn and implement, and have the potential for reducing intra- and postoperative complications, with very satisfactory functional and anatomical results.
References
Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538
Maher CM, Feiner B, Baessler K, Glazener CM (2011) Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J Pelvic Floor Dysfunct 22:1445–1457
Caquant F, Collinet P, Debodinance P, Berrocal J, Garbin O, Rosenthal C et al (2008) Safety of Trans Vaginal Mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res 34:449–456
Bako A, Dhar R (2009) Review of synthetic mesh-related complications in pelvic floor reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct 20:103–111
Marcus-Braun N, von Theobald P (2010) Mesh removal following transvaginal mesh placement: a case series of 104 operations. Int Urogynecol J Pelvic Floor Dysfunct 21:423–430
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Written informed consent was obtained from the patient for publication of this video article and any accompanying images.
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Marcus-Braun, N., von Theobald, P. Cystocele repair with single-incision, trocarless mesh system. Int Urogynecol J 25, 285–287 (2014). https://doi.org/10.1007/s00192-013-2159-y
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DOI: https://doi.org/10.1007/s00192-013-2159-y