Rodolfo Milani1, Stefano Manodoro2,3, Alice Cola1, Stefania Palmieri1, Claudio Reato1, Matteo Frigerio1. 1. ASST Monza, San Gerardo Hospital, Monza, Italy. 2. AUSL Romagna, Infermi Hospital, Rimini, Italy. stefano.manodoro@gmail.com. 3. AUSL della Romagna - Ospedale Infermi, U.O. Ostetricia e Ginecologia, Viale Luigi Settembrini 2, 47923, Rimini, RN, Italy. stefano.manodoro@gmail.com.
Abstract
INTRODUCTION AND HYPOTHESIS: Enterocele repair represents a challenge for pelvic surgeons. Surgical management implies enterocele sac removal. Subsequently, hernial port closure and adequate suspension may be achieved with Shull uterosacral ligament suspension (ULS). METHODS: A 55-year-old woman with symptomatic stage 3 enterocele was admitted for transvaginal uterosacral ligaments suspension according to the described technique. RESULTS: Surgical procedure was successfully achieved without complications. Final examination revealed excellent pelvic supports and preservation of vaginal length. This step-by-step video tutorial may represent an important tool to improve surgical know-how. CONCLUSIONS: Transvaginal uterosacral ligaments suspension provides a safe and effective technique for enterocele repair without the use of prosthetic materials. Identifying uterosacral ligaments, proper suture placement, and reapproximation of pubocervical and rectovaginal fascias with closure of the hernial port are the key points to achieve surgical success.
INTRODUCTION AND HYPOTHESIS: Enterocele repair represents a challenge for pelvic surgeons. Surgical management implies enterocele sac removal. Subsequently, hernial port closure and adequate suspension may be achieved with Shull uterosacral ligament suspension (ULS). METHODS: A 55-year-old woman with symptomatic stage 3 enterocele was admitted for transvaginal uterosacral ligaments suspension according to the described technique. RESULTS: Surgical procedure was successfully achieved without complications. Final examination revealed excellent pelvic supports and preservation of vaginal length. This step-by-step video tutorial may represent an important tool to improve surgical know-how. CONCLUSIONS: Transvaginal uterosacral ligaments suspension provides a safe and effective technique for enterocele repair without the use of prosthetic materials. Identifying uterosacral ligaments, proper suture placement, and reapproximation of pubocervical and rectovaginal fascias with closure of the hernial port are the key points to achieve surgical success.
Entities:
Keywords:
Enterocele; Native tissue repair; Pelvic organ prolapse; Uterosacral ligament suspension; Video tutorial
Authors: Seshadri Kasturi; Miriam Bentley-Taylor; Patrick J Woodman; Colin L Terry; Douglass S Hale Journal: Int Urogynecol J Date: 2012-03-09 Impact factor: 2.894
Authors: Christopher P Chung; Richard Miskimins; Thomas J Kuehl; Paul M Yandell; Bobby L Shull Journal: Int Urogynecol J Date: 2011-09-03 Impact factor: 2.894