Giovanni Panico1, Giuseppe Campagna2, Daniela Caramazza2, Nicola Amato3, Alfredo Ercoli4, Giovanni Scambia2, Mauro Cervigni2, Riccardo Zaccoletti3. 1. Department of Woman And Child Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. drgiovannipanico@gmail.com. 2. Department of Woman And Child Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. 3. Obstetrics and Gynecology Unit, P. Pederzoli Hospital, Peschiera del Garda, Verona, Italy. 4. Department of Obstetrics and Gynecology, Università degli Studi del Piemonte Orientale "Amedeo Avogadro", Maggiore Hospital, Novara, Italy.
Abstract
INTRODUCTION AND HYPOTHESIS: Uterovaginal prolapse treatment is a challenge for the urogynecologist. Surgical management for apical prolapse can be successful with native tissue and uterosacral ligament (USL) fixation. However, some complications have been described, especially with use of the vaginal approach. The aim of this video is to describe an alternative laparoscopic approach to a traditional vaginal procedure to reduce nerve injury and ureteral complications. METHODS: A 75-year-old woman was referred to our unit for symptomatic stage III apical prolapse and underwent laparoscopic USL fixation, according to the technique described herein. RESULTS: This surgical technique was successful in correcting apical prolapse. CONCLUSIONS: This video tutorial may be useful to urogynecologists for improving surgical technique, thus leading to a reduction in the risk of nerve and ureteral complications. The technique offers the possibility of a correct under-vision suture positioning. Laparoscopic USL fixation can be safely performed to treat apical prolapse.
INTRODUCTION AND HYPOTHESIS: Uterovaginal prolapse treatment is a challenge for the urogynecologist. Surgical management for apical prolapse can be successful with native tissue and uterosacral ligament (USL) fixation. However, some complications have been described, especially with use of the vaginal approach. The aim of this video is to describe an alternative laparoscopic approach to a traditional vaginal procedure to reduce nerve injury and ureteral complications. METHODS: A 75-year-old woman was referred to our unit for symptomatic stage III apical prolapse and underwent laparoscopic USL fixation, according to the technique described herein. RESULTS: This surgical technique was successful in correcting apical prolapse. CONCLUSIONS: This video tutorial may be useful to urogynecologists for improving surgical technique, thus leading to a reduction in the risk of nerve and ureteral complications. The technique offers the possibility of a correct under-vision suture positioning. Laparoscopic USL fixation can be safely performed to treat apical prolapse.
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Authors: Giuseppe Campagna; Lorenzo Vacca; Giovanni Panico; Giuseppe Vizzielli; Daniela Caramazza; Riccardo Zaccoletti; Monia Marturano; Roberta Granese; Martina Arcieri; Stefano Cianci; Giovanni Scambia; Alfredo Ercoli Journal: Front Med (Lausanne) Date: 2022-03-04