In patients who underwent only sacrospinous colpopexy, the time required to perform surgery was significantly lower in the csc group 20. Surgical anatomy and steps of the uterosacral ligament colpopexy. Sacrospinous definition is of or relating to a ligament on each side passing from the back of the sacrum to the spine of the ischium and converting the greater sciatic notch of the innominate bone into the greater sciatic foramen. To evaluate the results of sacrospinous colpopexy surgery associated with anterior colporrhaphy. An instructional video filmed using a telescopic, hd camera system.
Sacrospinous ligament suspension with transobturator mesh. Sacropinous ligament fixation is a surgical procedure used to correct bulging of the vagina, also known as prolapse of the vagina. To assess intra and postoperative complications and to look for long term followup results in women with sacrospinous ligament fixation. Longterm outcome of vaginal sacrospinous colpopexy for. Jul 26, 2017 hysterectomy is one of the most performed surgical procedures during lifetime. There is some controversy as to whether the abdominal route or the vaginal route results in optimum success 2, 3. Abdominal colposacropexy and sacrospinous ligament. Autoplay when autoplay is enabled, a suggested video will automatically play next. Laparoscopic sacral colpopexy versus total vaginal mesh for. Vaginal sacrospinous colpopexy using the capio suture. Sacrospinous fixationilleococcygeus suspension your.
In brief, a midline incision in the posterior vaginal wall starting from the hymenal ring to the vault to expose the recto vaginal space was performed. The sacrospinous ligament suspension technique was first described by karl richter in 1968 and later introduced into the united states by david h. Sacrospinous definition of sacrospinous by merriamwebster. A sacrospinous colpopexy will give added support to the top of the vagina. The sacrospinous ligament small or anterior sacrosciatic ligament is a thin, triangular ligament attached by its apex to the ischial spine, and medially, by its broad base, to the lateral margins of the sacrum and coccyx, in front of the sacrotuberous ligament with which its fibers are intermingled. A randomized prospective study was undertaken to compare the results of abdominal colposacropexy and sacrospinous ligament fixation in correcting severe uterovaginal prolapse.
Sacrospinous colpopexy was performed as previously reported. Women may experience what is known as vaginal prolapse, where the vaginal structure weakens and falls in on itself. Sacrospinous colpopexy, introduced to american gynecologists by randall and nichols 1 in 1971, has become a favored method for restoring vaginal support in women with vault prolapse, massive eversion of the vagina, or procidentia. Sacrospinous ligament vaginal vault suspension ex 2. An added advantage is that it helps maintain the length of the vagina. Vaginal sacrospinous colpopexy and laparoscopic sacral. Compare sacrospinous fixation versus high uterosacral. Hysterectomy is one of the most performed surgical procedures during lifetime. Concomitant surgery as vaginal hysterectomy andor anterior colporrhaphy was carried out first before the colpopexy. For incontinencesacral colpopexy nj center for prostate. The sacrospinous ligament small or anterior sacrosciatic ligament is a thin, triangular ligament attached by its apex to the ischial spine, and medially, by its broad base, to the lateral margins of the sacrum and coccyx, in front of the sacrotuberous ligament with which its.
Listing a study does not mean it has been evaluated by the u. Apr 06, 2020 colpopexy is a surgical procedure used to reposition a womans vagina that has moved from its correct physical location. Our goal was to determine how often a transvaginal sacrospinous colpopexy procedure can be done bilaterally. Ninetyfive women with vaginal vault prolapse were allocated randomly to sacral colpopexy 47 women or sacrospinous colpopexy 48 women. The surgical treatment of vaginal vault prolapse can either be performed by the vaginal or the abdominal laparoscopic route.
The present study compares the perioperative course and longterm results of vsc and lsc. It has been and continues to be an effective technique for apical suspension via the vaginal route, and is a valuable addition to the surgical. The objective success rate was 76% in the abdominal group and 69% in the vaginal group p. Introduction the incidence of uterovaginal prolapsed is on the increase in india. Hysteropexy in the treatment of uterine prolapse stage 2. Laparoscopic sacrocolpopexy versus vaginal sacrospinous.
A technique of performing a postpartum bilateral salpingectomy via mini laparotomy is presented. If all vaginal support defects are repaired at the time of sacral colpopexy, recurrent vault prolapse is rare. The procedure is quite complicated and ensuring surgical. Approximately 30% of the women had late complications.
Impact of sacrospinous colpopexy associated with anterior. Results for sacrospinous colpopexy 1 9 of 9 sorted by relevance date click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. This is the surgery that is used for pelvic organ prolapse in which the vagina is prolapsing into the vaginal canal or outside the opening of the vagina. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for. Sacrospinous ligament fixation for vaginal vault prolapse. The abdominal approach was associated with a longer operating time, a slower return to activities of daily living, and a greater cost than the sacrospinous colpopexy p colpopexy and the vaginal sacrospinous colpopexy are equally effective in the treatment of vaginal vault prolapse. Abdominal sacral colpopexy or vaginal sacrospinous. Oct 01, 2010 the sacrospinous ligament suspension technique was first described by karl richter in 1968 and later introduced into the united states by david h. In the csc group, the mean operative time required to perform sacrospinous colpopexy was 21. Sacrospinous vault fixation for vault prolapse video. The abdominal approach was associated with a longer operating time, a slower return to activities of daily living, and a greater cost than the sacrospinous colpopexy p video presentation 07 prevention, recognition, and management of complications associated with sacrospinous colpopexy a. Abdominal sacral colpopexy is still the gold standard for. Reducing postop pain after sacrospinous ligament colpopexy. Pronunciation of colpopexy with 1 audio pronunciation and more for colpopexy.
Sacral colpopexy, also known as sacrocolpopexy or sacrospinous colpopexy, is a surgical procedure used to correct pelvic organ prolapse in women. Sacrospinous ligament suspension, with and without mesh. This is a fairly common occurrence in women who have. Sacrospinous fixationilleococcygeus suspension prolapse of the vagina or uterus is a common condition with up to 11% of women requiring surgery during their lifetime. Medical definition of sacrospinous ligament merriam. In total, 41 of the 89 women underwent sacrospinous ligament suspension, and 48 of the women underwent abdominal sacral colpopexy. Prolapse often occurs as a result of damage to the support structures of the uterus and vagina. This study compared a prospective cohort of lsc with boneanchor fixation and mesh limited to the apex to a prospective cohort of. Colpopexy is a surgical procedure used to reposition a womans vagina that has moved from its correct physical location. Abdominal colposacropexy and sacrospinous ligament suspension. Laparoscopic sacral colpopexy versus total vaginal mesh. Colpopexy onto the sacrospinous ligament for the treatment of vault prolapse is commonly used in vaginal surgery and became popular in europe and the united states in the 1970s.
Laparoscopic sacral colpopexy for vault prolapse youtube. Each of the above operations has its own set of complications 1. Mean blood loss was 456 ml, and mean operating time was 163 minutes. One way is to use sutures, so as to resuspend the vagina. This video demonstrates our technique of performing a lap sacral colpopexy for vaginal vault prolapse. This retrospective study of posthysterectomy vault prolapse involved 111 patients operated with either vsc n51 or lsc n60.
One procedure was converted to a sacrospinous ligament suspension. It has been and continues to be an effective technique for apical suspension via the vaginal route, and is a valuable addition to the surgical armamentarium of. Diagrammatic representation of the surgery is shown below or see video. In the 4 previous years that i have attended this meeting, seven studies have been presented on the subject. Pelvic organ prolapse has significant negative effects on a womans quality of life.
This is sacral colpopexy by swelker on vimeo, the home for high quality videos and the people who love them. A sacrospinouscolpopexy, introduced by randall and nichols in 1971, has become a favored method for. Prolapse of the vagina or uterus is a common condition with up to 11% of women requiring surgery during their lifetime. Reducing postop pain after sacrospinous ligament colpopexy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Laparoscopic sacral colpopexy and sacrospinous fixation. Between 1991 and 1996, 8 women with uterine prolapse or vaginal vault eversion greater than stage iii ics grading system were enrolled. Up next pelvic floor part 1 the pelvic diaphragm 3d anatomy tutorial duration. The gold standard is abdominal sacral colpopexy, which has the lowest rate of longterm failure of all the procedures. Procedure sacrospinous colpopexy is usually performed under general anaesthesia, but, can be done with a regional block. In relation to the women included in the study, 40. A minimally invasive approach for advanced pelvic organ prolapse.
Technique description synopsis of video when surgical repair is indicated for vaginal vault prolapse, either vaginal or transabdominal approach is feasible, however, higher success rate has been reported for the transabdominal approach 1. Usually reserved for recurrent prolapse of the upper vagina recurrent cystocele, vault or enterocele or massive vaginal eversion. Laparoscopic sacrospinous ligament section is a surgical therapeutic alternative in selected cases with partial response to local infiltration and hydrodistention of pudendal nerve interligament entrapment. What will happen if i choose not to have a sacrospinous colpopexy. Often inadequate vault suspension during surgery is the leading cause. Powerpoint presentation of indications, limits and complications. The objective of this study was to compare the laparoscopic sacral colpopexy lsc and total vaginal mesh tvm for vaginal vault prolapse. This study compares the feasibility and outcome of sacrospinous colpopexy for treating vaginal vault prolapse vvp performed by either the traditional technique or a simplified procedure using the capio suturecapturing device. Rates of success defined as no apical prolapse with sacral colpopexy range from 78% to 100% and the mean reoperation rate is 4. We intend to report 57288, 5728251, 5728251, 5726051, and 5726751.
For younger women or those not desiring to undergo hysterectomy, a sacrocolpopexy may be performed to recreate the normal suspended uterus without the need. Clear illustration of sacrospinous vault fixation for vault prolapse edited by dr sanjiv vigneshwara. Vaginal sacrospinous colpopexy and laparoscopic sacral colpopexy for vaginal vault prolapse. This video is limited to doctors and other health professionals. A colpopexy is a surgical procedure to resuspend the colpus vagina into the abdomen.
Worldwide, vaginal hysterectomy is the leading treatment method for patients with symptomatic uterovaginal prolapse. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy. This study compared a prospective cohort of lsc with boneanchor fixation and mesh limited to the. It is usually done in conjunction with repair of the vaginal walls. Sacrospinous fixationilleococcygeus suspension your pelvic. A variety of operations now exists for the treatment of vaginal vault prolapse and the reestablishment of apical supportfrom abdominal sacral colpopexy and abdominal uterus sacral suspensions, to sacrospinous vaginal vault suspensions, sacrospinous hysteropexies, and iliococcygeal vaginal vault suspensions. Dec 01, 2007 a variety of operations now exists for the treatment of vaginal vault prolapse and the reestablishment of apical supportfrom abdominal sacral colpopexy and abdominal uterus sacral suspensions, to sacrospinous vaginal vault suspensions, sacrospinous hysteropexies, and iliococcygeal vaginal vault suspensions. Jan 15, 2014 reducing postop pain after sacrospinous ligament colpopexy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Vaginal vault prolapse can be corrected by many different surgical procedures. Abdominal sacral colpopexy with retroperitoneal interposition of a suspensory hammock between a prolapsed vaginal vault and the anterior surface of the sacrum was performed on 163 women for. Aug 14, 2016 combined sacrospinous hysteropexy and cystopexy through cystopexy incision. Vaginal sacrospinous colpopexy vsc and laparoscopic sacral colpopexy lsc both correct vault prolapse. The transabdominal repair may be preferred after failed vaginal. Robotic surgery for incontinencesacral colpopexy sacrocolpopexy is performed for those patients with a dropped or poorly suspended uterus or uterine prolapse.
Abdominal sacral colpopexy versus sacrospinous ligament fixation. Abdominal techniques for surgical management of vaginal vault. Sacrospinous colpopexy has, since its description in 1968, become a commonly used procedure for the treatment of vaginal vault prolapse after hysterectomy. Almost 10 % of women who have had a hysterectomy because of prolapse symptoms, will visit a gynaecologist for a surgical correction of a vaginal vault prolapse thereafter. Surgical repair of apical prolapse using vaginal sacral colpopexy. Abstract sixtynine patients with vaginal vault prolapse or enterocele were treated with 70 sacrospinous ligament fixation procedures over 9. Concomitant with the sacrospinous ligament fixation, 3 vaginal hysterectomies, 32 anterior colporrhaphies, 44 posterior colporrhaphies, 16 pereyra, and 3 kelly procedures were performed. Sacrospinous colpopexy is a simple, effective and safe technique that can be performed either by itself or as an adjunct to vaginal hysterectomy keywords.
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