Laparoscopic sacrocolpopexy
| Autor: | Gabriel N. Schaer, Thomas Aigmueller, Heimo Magg, Dimitri Sarlos |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
business.industry Pelvic pain media_common.quotation_subject Obstetrics and Gynecology Urination Surgery Hypogastric nerve medicine.nerve Dissection medicine.anatomical_structure Vagina medicine Superior hypogastric plexus Ligament medicine.symptom business Vaginal Vault Prolapse media_common |
| Zdroj: | American Journal of Obstetrics and Gynecology. 212:824.e1-824.e3 |
| ISSN: | 0002-9378 |
| DOI: | 10.1016/j.ajog.2014.12.005 |
| Popis: | Laparoscopic sacrocolpopexy is a well-established technique to treat apical vaginal prolapse. De novo micturition disorders, pelvic pain, and defecation disorders have been reported and may be due to intraoperative compromise of the superior hypogastric plexus. The video demonstrates our technique for nerve-sparing laparoscopic sacrocolpopexy. The patient is a 62-year-old woman with symptomatic stage III posthysterectomy vaginal vault prolapse. Key steps of the procedure are opening the peritoneum at the level of the promontory, identification of the fibers of the superior hypogastric plexus, deep anterior and posterior dissection with attachment of the mesh to the vagina, displacement of the nerve fibers to the left side during suturing of the mesh to the longitudinal ligament, and complete peritonealization. This technique of the identification and protection of relevant nerve structures appears to be reproducible and can be considered by surgeons who perform laparoscopic sacrocolpopexy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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