Hoshino Kaori
   Department   University Hospital  Obstetrics and Gynecology, Clinical Departments
Article types journal article
Language English
Peer review Peer reviewed
Title Laparoscopic fixation of the vaginal cuff to the uterosacral ligaments at the time of hysterectomy.
Journal Formal name:International urogynecology journal
Abbreviation:Int Urogynecol J
ISSN code:14333023/09373462
Domestic / ForeginForegin
Publisher Springer London
Volume, Issue, Page 28(2),321-323頁
Author and coauthor Nishimura Kazuaki, Yoshimura Kazuaki, Hoshino Kaori, Hachisuga Toru
Publication date 2017/02
Summary INTRODUCTION AND HYPOTHESIS:Transvaginal ipsilateral uterosacral ligament colpopexy for pelvic organ prolapse (POP), which was reported by Shull et al. (Shull's colpopexy) in 2000, is one of the most frequently performed non-mesh pelvic floor reconstructive surgical procedures. Despite its excellent anatomical outcomes, ureteral injury and difficulty in uterosacral ligament detection (especially in patients with severe POP) are typical issues with this procedure.METHOD:This video demonstrates the procedure in a 58-year-old woman, gravida 2 para 2, with POP-Q stage II uterine prolapse and stage I cystocele. At the beginning of the operation, the bilateral uterosacral ligaments were confirmed and separated from the ureters after entering the retroperitoneal space. The inferior hypogastric nerve and pelvic nerve plexus were also separated from the uterosacral ligament. After total laparoscopic hysterectomy, three ipsilateral delayed absorbable monofilament sutures were placed between the uterosacral ligament and the vaginal cuff. Retroperitonealization was then performed using a continuous suture with closure of the Douglas pouch.CONCLUSION:Laparoscopic Shull's colpopexy for POP is a secure procedure with the advantages of laparoscopy (magnification and sharing the operative field). This may become one of the most useful operations for apical support as native tissue repair.
DOI 10.1007/s00192-016-3137-y
PMID 27614758