Aim: We demonstrate a novel box stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension for apical prolapse in restorative pelvic reconstructive surgery.
Material And Methods: We present a case of a 58yo female with symptomatic stage III pelvic organ prolapse with a history of a total abdominal hysterectomy 30 years prior. She strongly desired the usage of no synthetic or biologic mesh for her restorative surgical repair. This video provides a step-by-step guide on how to perform a laparoscopic box stitch as a technique for uterosacral ligament suspension as an apical native tissue option for patients with the need for post hysterectomy apical prolapse.
Conclusion: This video demonstrates a novel box-stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension as a native tissue option for minimally invasive reconstructive surgery. The procedure is a reasonable option to address apical prolapse in patients who do not desire or who are unable to have synthetic or biologic mesh placed for restorative reconstructive prolapse surgery.
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http://dx.doi.org/10.1007/s00192-017-3335-2 | DOI Listing |
Int Urogynecol J
January 2025
Department of Obstetrics and Gynecology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, China.
Introduction And Hypothesis: Pelvic organ prolapse (POP) impacts women's health and quality of life. Post-surgery complications can be severe. This study uses rat models to replicate sacrocolpopexy and test materials for pelvic support, verifying the 4-week postoperative mortality rate, the mechanical properties of the mesh tissue, and the collagen content.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
December 2024
Department of Mechanical Science and Engineering, University of Illinois Urbana-Champaign, IL, USA; Department of Bioengineering, University of Illinois Urbana-Champaign, IL, USA; Beckman Institute, University of Illinois Urbana-Champaign, IL, USA; Materials Research Laboratory, University of Illinois Urbana-Champaign, IL, USA; Institute for Genomic Biology, University of Illinois Urbana-Champaign, IL, USA; Grainger College of Engineering, University of Illinois Urbana-Champaign, IL, USA.
Pelvic organ prolapse is a debilitating condition that diminishes quality of life, and it has been linked to pregnancy and aging. Injury of the uterosacral ligaments (USLs), which provide apical support to the pelvic organs, is a major cause of uterine prolapse. In this study, we examined the effect of pregnancy and age on the apparent elastic modulus, susceptibility to collagen damage, and extracellular matrix (ECM) composition of the murine USL.
View Article and Find Full Text PDFUrogynecology (Phila)
December 2024
From the Division of Urogynecology, TriHealth, Cincinnati, OH.
Importance: Electrosurgical vessel sealing devices for vaginal hysterectomy have demonstrated reduced postoperative pain. This modality, however, has not been evaluated in patients undergoing vaginal hysterectomy with pelvic reconstruction.
Objective: The aim of the study was to describe postoperative pain levels utilizing the LigaSure vessel sealing device for vaginal hysterectomy in patients undergoing major reconstructive surgery.
J Clin Med
November 2024
Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
This study investigated patient pain descriptors for transvaginal ultrasound (TVS) diagnostic evaluation of endometriosis for uterosacral ligaments (USLs), including correlation between USL thickness and site-specific tenderness (SST). It further investigated if SST could positively assist diagnosing endometriosis on TVS. TVS images and SST pain descriptors were collected from 42 patients.
View Article and Find Full Text PDFNeurourol Urodyn
November 2024
Pelvic Floor Surgeon (retired).
Aims: To provide a brief anatomical pathogenesis of the Working Group SUI publication recommendations.
Methods And Results: The anatomical science and surgical practice presented here formed the original basis for the MUS and other bladder dysfunctions, updated to 2024 with videos: https://atm.amegroups.
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