We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.
Filter by
Specialty
View more
Technologies
View more
Clear filter Media type
View more
Clear filter Category
View more
Publication date
Sort by:
Laparoscopic rectal shaving for rectocervical endometriotic nodule
This is the case of a 32-year-old G0P0 woman presenting with severe dysmenorrhea, severe dyspareunia, and constipation. Pelvic examination showed a normal vagina, a fixed uterus, and mobile adnexae. Transvaginal ultrasonography (TvUSG) showed that the uterus and both ovaries were normal. A left parasalpingeal endometrioma (15mm), an obliterated Douglas pouch, as well as rectocervical and infiltrated rectal nodules (18mm and 0.6mm respectively) were also evidenced. Since bilateral ovaries were fixed to the pelvic sidewall, the operative strategy included bilateral ureterolysis and dissection of the hypogastric nerve and the pararectal fossa. Finally, the rectocervical nodule was mobilized by performing cervical and rectal shaving. The rectum was controlled by means of a methylene blue test. The final pathology was endometriosis.
H Altuntaş
Surgical intervention
1 year ago
5742 views
490 likes
0 comments
06:58
Laparoscopic rectal shaving for rectocervical endometriotic nodule
This is the case of a 32-year-old G0P0 woman presenting with severe dysmenorrhea, severe dyspareunia, and constipation. Pelvic examination showed a normal vagina, a fixed uterus, and mobile adnexae. Transvaginal ultrasonography (TvUSG) showed that the uterus and both ovaries were normal. A left parasalpingeal endometrioma (15mm), an obliterated Douglas pouch, as well as rectocervical and infiltrated rectal nodules (18mm and 0.6mm respectively) were also evidenced. Since bilateral ovaries were fixed to the pelvic sidewall, the operative strategy included bilateral ureterolysis and dissection of the hypogastric nerve and the pararectal fossa. Finally, the rectocervical nodule was mobilized by performing cervical and rectal shaving. The rectum was controlled by means of a methylene blue test. The final pathology was endometriosis.
Laparoscopic anatomy of the pelvic floor involved in laparoscopic surgery for pelvic organ prolapse (POP) and urinary incontinence
In this key lecture, Professor Jean-Bernard Dubuisson delineates the laparoscopic pelvic floor anatomy involved in surgical procedures for the management of pelvic organ prolapse (POP) and urinary incontinence. Traditional anatomy considers three levels: pelvic and perineal muscles, ligaments, and the space between all fascias covering the organs. Visceral ligaments occupy an anteroposterior axis (pubovesical ligaments, bladder pillars, and uterosacral ligaments) and a transverse axis (lateral bladder ligaments, cardinal ligaments, paracervix and rectal pillars). The four attachment sites which may be used by the surgeon for fascia and pelvic organ attachment in POP surgery are discussed-- Cooper’s ligament, white line, ischial spine, and sacral promontory. Approximately 90 laparoscopic anatomy pictures are presented in this authoritative lecture. The dissection planes and the different pelvic spaces used for surgery are explained, insisting on the main vessels, nerves, plexus, ureters which are obstacles to bear in mind and to avoid.
JB Dubuisson
Lecture
2 years ago
5042 views
614 likes
0 comments
24:09
Laparoscopic anatomy of the pelvic floor involved in laparoscopic surgery for pelvic organ prolapse (POP) and urinary incontinence
In this key lecture, Professor Jean-Bernard Dubuisson delineates the laparoscopic pelvic floor anatomy involved in surgical procedures for the management of pelvic organ prolapse (POP) and urinary incontinence. Traditional anatomy considers three levels: pelvic and perineal muscles, ligaments, and the space between all fascias covering the organs. Visceral ligaments occupy an anteroposterior axis (pubovesical ligaments, bladder pillars, and uterosacral ligaments) and a transverse axis (lateral bladder ligaments, cardinal ligaments, paracervix and rectal pillars). The four attachment sites which may be used by the surgeon for fascia and pelvic organ attachment in POP surgery are discussed-- Cooper’s ligament, white line, ischial spine, and sacral promontory. Approximately 90 laparoscopic anatomy pictures are presented in this authoritative lecture. The dissection planes and the different pelvic spaces used for surgery are explained, insisting on the main vessels, nerves, plexus, ureters which are obstacles to bear in mind and to avoid.
Colorectal resection in deep endometriosis: multidisciplinary laparoscopic approach (colorectal and gynecologic surgical teams)
In this video, we present the clinical case of a 42-year-old woman with deep pelvic endometriosis with rectal infiltration. After hormone therapy, the patient was operated on due to chronic pain. A laparoscopic approach was performed by a multidisciplinary team including colorectal and gynecologic surgeons having a wide experience in this field.
A CT-scan, MRI, and colonoscopy were performed before the surgery showing a deep infiltrating endometriosis with anterior rectal bowel involvement in the images and normal colorectal mucosa in the endoscopy.
Under general anesthesia, the laparoscopic approach was performed with 4 trocars. Deep infiltrating endometriosis (DIE) required a hysterectomy and rectal resection to clean all the pelvic space. An end-to-end colorectal anastomosis was performed and the extraction of the specimen (uterus and rectum) was carried out transvaginally. The patient was discharged on postoperative day 4 without complications.
JF Noguera, MD, PhD, J Gilabert-Estelles, J Aguirrezabalaga, B López, J Dolz
Surgical intervention
2 years ago
3213 views
304 likes
1 comment
09:55
Colorectal resection in deep endometriosis: multidisciplinary laparoscopic approach (colorectal and gynecologic surgical teams)
In this video, we present the clinical case of a 42-year-old woman with deep pelvic endometriosis with rectal infiltration. After hormone therapy, the patient was operated on due to chronic pain. A laparoscopic approach was performed by a multidisciplinary team including colorectal and gynecologic surgeons having a wide experience in this field.
A CT-scan, MRI, and colonoscopy were performed before the surgery showing a deep infiltrating endometriosis with anterior rectal bowel involvement in the images and normal colorectal mucosa in the endoscopy.
Under general anesthesia, the laparoscopic approach was performed with 4 trocars. Deep infiltrating endometriosis (DIE) required a hysterectomy and rectal resection to clean all the pelvic space. An end-to-end colorectal anastomosis was performed and the extraction of the specimen (uterus and rectum) was carried out transvaginally. The patient was discharged on postoperative day 4 without complications.
Laparoscopic resection of endometriotic fibrotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels and adherent to the mid-sigmoid colon
Deep endometriosis is one of the most complex and risky surgeries. Its laparoscopic management requires a systematic approach, a good anatomical knowledge, and a high level of surgical competency.
This is the case of a 37-year-old lady presenting with a complex deep pelvic endometriosis. She had a long history of severe dysmenorrhea, colicky abdominal pain, back pain, and constipation. Imaging studies (MR) showed a large fibrotic endometriotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels, nerves, and adherent to a 4cm segment of the mid-sigmoid colon.
This patient has a complicated past history of left ureter ligation during a caesarean section (in 2011), which resulted in a left-sided nephrectomy in 2012. She got a pneumothorax complication, lung drainage, right-side thoracotomy in 2013, and finally a total pleurectomy in 2014.
A Wattiez, R Nasir, I Argay
Surgical intervention
2 years ago
5445 views
314 likes
1 comment
42:42
Laparoscopic resection of endometriotic fibrotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels and adherent to the mid-sigmoid colon
Deep endometriosis is one of the most complex and risky surgeries. Its laparoscopic management requires a systematic approach, a good anatomical knowledge, and a high level of surgical competency.
This is the case of a 37-year-old lady presenting with a complex deep pelvic endometriosis. She had a long history of severe dysmenorrhea, colicky abdominal pain, back pain, and constipation. Imaging studies (MR) showed a large fibrotic endometriotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels, nerves, and adherent to a 4cm segment of the mid-sigmoid colon.
This patient has a complicated past history of left ureter ligation during a caesarean section (in 2011), which resulted in a left-sided nephrectomy in 2012. She got a pneumothorax complication, lung drainage, right-side thoracotomy in 2013, and finally a total pleurectomy in 2014.
Endometrial cancer surgical indications
The surgical management of endometrial cancer has been markedly changed by minimally invasive techniques. After three decades of laparoscopy, robotic surgery has built upon and expanded the population of patients able to benefit from minimally invasive techniques. Updates in the field of laparoscopy continue, including single site surgery. The emergence and rapid uptake of robotics continues to produce favorable outcomes while simultaneously expanding minimal access surgery to the obese and elderly populations. Sentinel lymph node detection and single port surgery are expanding areas which will continue to push the role of minimally invasive surgery (MIS) in endometrial cancer. In this key lecture, Dr. Querleu will discuss the role of MIS in the management of endometrial cancer.
D Querleu
Lecture
2 years ago
1461 views
103 likes
0 comments
29:34
Endometrial cancer surgical indications
The surgical management of endometrial cancer has been markedly changed by minimally invasive techniques. After three decades of laparoscopy, robotic surgery has built upon and expanded the population of patients able to benefit from minimally invasive techniques. Updates in the field of laparoscopy continue, including single site surgery. The emergence and rapid uptake of robotics continues to produce favorable outcomes while simultaneously expanding minimal access surgery to the obese and elderly populations. Sentinel lymph node detection and single port surgery are expanding areas which will continue to push the role of minimally invasive surgery (MIS) in endometrial cancer. In this key lecture, Dr. Querleu will discuss the role of MIS in the management of endometrial cancer.
Severe complex endometriosis with ascites: laparoscopic management
Frozen pelvis due to endometriosis is one of the most complex and risky situations which surgeons sometimes face. Its laparoscopic management requires a systematic approach, a good anatomical knowledge and a high level of surgical competency. This is a frozen pelvis case secondary to a complicated severe endometriosis in a young nulliparous lady. She had hemorrhagic abdominal ascites secondary to endometriosis, with a sub-occlusive syndrome. Her disease was further complicated with upper abdominal and pelvic fibrosis with a large umbilical endometriotic nodule as well as splenic, omental and sigmoid endometriosis. This video demonstrates the strategy of the laparoscopic management of this condition.
A Wattiez, R Nasir, A Host
Surgical intervention
3 years ago
4070 views
162 likes
0 comments
31:22
Severe complex endometriosis with ascites: laparoscopic management
Frozen pelvis due to endometriosis is one of the most complex and risky situations which surgeons sometimes face. Its laparoscopic management requires a systematic approach, a good anatomical knowledge and a high level of surgical competency. This is a frozen pelvis case secondary to a complicated severe endometriosis in a young nulliparous lady. She had hemorrhagic abdominal ascites secondary to endometriosis, with a sub-occlusive syndrome. Her disease was further complicated with upper abdominal and pelvic fibrosis with a large umbilical endometriotic nodule as well as splenic, omental and sigmoid endometriosis. This video demonstrates the strategy of the laparoscopic management of this condition.
Laparoscopic dissection of sacral promontory for sacrocolpopexy
Objective: To describe the laparoscopic dissection of the sacral promontory during a laparoscopic sacrocolpopexy, with a special focus on anatomical landmarks and surgical traps.
Setting: Department of Gynecology, CMCO, Strasbourg University Hospital, France.
Patients: Women with invalidating genital prolapse
Interventions: Laparoscopic sacrocolpopexy is performed using three operative ports (one midline, suprapubic port and two lateral ports) and a 0-degree umbilical Karl Storz optical port. In order to suture a polypropylene mesh to the anterior vertebral ligament, the promontory area must be dissected. To improve sacral promontory exposure, the rectum is usually suspended to the left anterior abdominal wall by means of T’Lift™ tissue retraction systems. By palpating the area under the aortic bifurcation and the confluence of iliac veins, the sacral promontory is identified. The right ureter is also identified. Using two duck jaw fenestrated forceps, the peritoneum is lifted --retroperitoneal vessels are fixed to the vertebral elements, and widely opened. The promontory is carefully dissected until the anterior vertebral ligament becomes visible. As the presacral space is rich in blood vessels and nerve elements, surgeons are advised to preserve it.
However, the surgical approach to the vertebral ligament is sometimes difficult in obese women, when patients present anatomical variations such as a low iliac venous circulation confluence, a duplicity of middle sacral vessels, periosteal perforators, a winding right common iliac artery, or in the presence of lymph nodes.
Discussion: Laparoscopic sacrocolpopexy complications rates such as bleeding originating from the promontory varying from 0 to 4.7%, which sometimes require conversion to open abdominal sacrocolpopexy. Described by radiologists at almost 3cm from the sacral promontory, the right ureter can also be injured during reperitonization.
Conclusion: Laparoscopic dissection of the promontory requires specific and careful attention to be paid to non-infrequent anatomical variations.
V Gabriele, AJ Carin, K Afors, O Garbin
Surgical intervention
4 years ago
5508 views
230 likes
1 comment
07:24
Laparoscopic dissection of sacral promontory for sacrocolpopexy
Objective: To describe the laparoscopic dissection of the sacral promontory during a laparoscopic sacrocolpopexy, with a special focus on anatomical landmarks and surgical traps.
Setting: Department of Gynecology, CMCO, Strasbourg University Hospital, France.
Patients: Women with invalidating genital prolapse
Interventions: Laparoscopic sacrocolpopexy is performed using three operative ports (one midline, suprapubic port and two lateral ports) and a 0-degree umbilical Karl Storz optical port. In order to suture a polypropylene mesh to the anterior vertebral ligament, the promontory area must be dissected. To improve sacral promontory exposure, the rectum is usually suspended to the left anterior abdominal wall by means of T’Lift™ tissue retraction systems. By palpating the area under the aortic bifurcation and the confluence of iliac veins, the sacral promontory is identified. The right ureter is also identified. Using two duck jaw fenestrated forceps, the peritoneum is lifted --retroperitoneal vessels are fixed to the vertebral elements, and widely opened. The promontory is carefully dissected until the anterior vertebral ligament becomes visible. As the presacral space is rich in blood vessels and nerve elements, surgeons are advised to preserve it.
However, the surgical approach to the vertebral ligament is sometimes difficult in obese women, when patients present anatomical variations such as a low iliac venous circulation confluence, a duplicity of middle sacral vessels, periosteal perforators, a winding right common iliac artery, or in the presence of lymph nodes.
Discussion: Laparoscopic sacrocolpopexy complications rates such as bleeding originating from the promontory varying from 0 to 4.7%, which sometimes require conversion to open abdominal sacrocolpopexy. Described by radiologists at almost 3cm from the sacral promontory, the right ureter can also be injured during reperitonization.
Conclusion: Laparoscopic dissection of the promontory requires specific and careful attention to be paid to non-infrequent anatomical variations.
Laparoscopic treatment of bilateral endometriotic cysts
The different surgical approaches to ovarian endometriosis are the following: ovarian cystectomy, endometrioma fenestration and removal, or a technique combining cystectomy and removal.
In order to perform a cystectomy without damaging the ovary, different steps must be followed, including adhesiolysis between the ovary and the broad ligament, cyst opening at the site of eversion and adhesion. Traction and counter-traction allow to separate the cyst’s wall from the ovarian cortex. As the endometrioma is surrounded by a fibrotic capsule, there is a risk of removing normal ovarian tissue and ovocytes. Blood vessels must be identified and selective coagulation must be performed to prevent destruction of the normal ovarian tissue.
Endometrioma fenestration and removal can be performed with different sources of energy such as bipolar coagulation, carbon dioxide laser and plasma energy. Depending on the size of the endometrioma, the removal technique can be performed in one or three steps. But to avoid 2 laparoscopic procedures, a combined technique of excision and removal of the endometrioma could be offered in cases of large cysts.
Medical treatment is administered preoperatively only in cases of pelvic pain and postoperatively in cases of pelvic pain and if there is no desire for pregnancy.
According to a recent systematic review and meta-analysis, the ovarian reserve, evaluated by the AMH level, is affected by surgery, and even more in cases of bilateral cysts.

To conclude, ovarian endometrioma surgery requires a learning curve to prevent ovarian damage, which can be caused by normal ovarian tissue removal or by a strong coagulation. Repetitive surgery has to be clearly evaluated as it is also responsible for ovarian reserve decrease.
M Nisolle
Lecture
4 years ago
2601 views
96 likes
0 comments
19:00
Laparoscopic treatment of bilateral endometriotic cysts
The different surgical approaches to ovarian endometriosis are the following: ovarian cystectomy, endometrioma fenestration and removal, or a technique combining cystectomy and removal.
In order to perform a cystectomy without damaging the ovary, different steps must be followed, including adhesiolysis between the ovary and the broad ligament, cyst opening at the site of eversion and adhesion. Traction and counter-traction allow to separate the cyst’s wall from the ovarian cortex. As the endometrioma is surrounded by a fibrotic capsule, there is a risk of removing normal ovarian tissue and ovocytes. Blood vessels must be identified and selective coagulation must be performed to prevent destruction of the normal ovarian tissue.
Endometrioma fenestration and removal can be performed with different sources of energy such as bipolar coagulation, carbon dioxide laser and plasma energy. Depending on the size of the endometrioma, the removal technique can be performed in one or three steps. But to avoid 2 laparoscopic procedures, a combined technique of excision and removal of the endometrioma could be offered in cases of large cysts.
Medical treatment is administered preoperatively only in cases of pelvic pain and postoperatively in cases of pelvic pain and if there is no desire for pregnancy.
According to a recent systematic review and meta-analysis, the ovarian reserve, evaluated by the AMH level, is affected by surgery, and even more in cases of bilateral cysts.

To conclude, ovarian endometrioma surgery requires a learning curve to prevent ovarian damage, which can be caused by normal ovarian tissue removal or by a strong coagulation. Repetitive surgery has to be clearly evaluated as it is also responsible for ovarian reserve decrease.
DIE and laparoscopic treatment
Hormone therapy was designed to suppress estrogen synthesis and to reduce the size of ectopic endometrial implants. However, the recurrence of pain after cessation is estimated at 50% and indicates that surgery is required for symptomatic patients.
Conservative surgery is effective in terms of pain reduction if complete excision is obtained, and consequently a preoperative assessment is mandatory to put forward a multidisciplinary approach in specialized centers.
In cases of excision of the nodular lesion by means of mucosal skinning, the resection of uterosacral ligaments and of the posterior vaginal fornix is usually recommended. A comparison between standard and reverse laparoscopic techniques demonstrated a statistically significant lower rate of major postoperative complications by using the reverse technique.
Bowel endometriosis requires bowel resection if the size is estimated to exceed 3cm, to affect 50% of the bowel's diameter or to induce a stenosis. Different techniques could be proposed such as a segmental bowel resection, a discoid resection or a stapled resection.
Concerning the rate of complications, it has been published that mucosal skinning is associated with fewer complications than segmental resection.
Recently, robotic assisted laparoscopy was used for the treatment of advanced stage endometriosis; however, it is associated with an increased operative time and a longer hospital stay.

To conclude, a skilled surgical team is necessary to perform the complete removal of lesions without increasing the risk of complications and to obtain good results in terms of pelvic pain and fertility.
M Nisolle
Lecture
4 years ago
1862 views
78 likes
0 comments
23:49
DIE and laparoscopic treatment
Hormone therapy was designed to suppress estrogen synthesis and to reduce the size of ectopic endometrial implants. However, the recurrence of pain after cessation is estimated at 50% and indicates that surgery is required for symptomatic patients.
Conservative surgery is effective in terms of pain reduction if complete excision is obtained, and consequently a preoperative assessment is mandatory to put forward a multidisciplinary approach in specialized centers.
In cases of excision of the nodular lesion by means of mucosal skinning, the resection of uterosacral ligaments and of the posterior vaginal fornix is usually recommended. A comparison between standard and reverse laparoscopic techniques demonstrated a statistically significant lower rate of major postoperative complications by using the reverse technique.
Bowel endometriosis requires bowel resection if the size is estimated to exceed 3cm, to affect 50% of the bowel's diameter or to induce a stenosis. Different techniques could be proposed such as a segmental bowel resection, a discoid resection or a stapled resection.
Concerning the rate of complications, it has been published that mucosal skinning is associated with fewer complications than segmental resection.
Recently, robotic assisted laparoscopy was used for the treatment of advanced stage endometriosis; however, it is associated with an increased operative time and a longer hospital stay.

To conclude, a skilled surgical team is necessary to perform the complete removal of lesions without increasing the risk of complications and to obtain good results in terms of pelvic pain and fertility.
The indications of transvaginal endoscopy for diagnosis and treatment of infertility
Standard laparoscopy is frequently postponed and omitted in the exploration of the infertile patient. It is a rather invasive and not innocuous procedure. However, direct endoscopic visualization of the pelvis and the uterine cavity is still considered the gold standard and it is preferred over indirect imaging techniques.
The transvaginal single access approach offers the opportunity to explore the uterus and tubo-ovarian organs in an ambulatory “one-stop fertility” clinical setting. Only direct visualization of the pelvis allows for an accurate diagnosis of minimal endometriosis, tubo-ovarian adhesions, sequellae of PID. When indicated, the procedure was completed with a patency test, salpingoscopy and hysteroscopy. In patients without obvious pelvic pathology, transvafinal endoscopy (TVE) can be used as a first-line diagnostic procedure without postponing an early diagnosis and accurate therapy.
Because of the easy access to the fossa ovarica, the preferred implantation site of endometriosis, limited surgical procedures such as adhesiolysis become possible, the same goes for the treatment of ovarian endometrioma, and ovarian drilling. It allows for an accurate and meticulous dissection of peri-ovarian adhesions and hydroflotation is very helpful in the identification of the exact cleavage plane between the different organs. Small scissors, forceps, and a bipolar coagulation probe are used. A meticulous hemostasis is mandatory, as bleeding will disturb visualization in a watery medium. In case of endometriosis, after the endometrioma has been opened, the chocolate fluid is removed and the inner site of the cyst is superfluously rinsed. The bipolar probe is used to fulgurate the inner endometrial layering.
To drill the ovarian capsule, we use a 5 French bipolar needle (Karl Storz, Tuttlingen, Germany). On each ovary, 5 to 10 punctures were created preferentially at the antero-lateral side of the ovary. The 5 French bipolar needle is gently pushed against the ovarian surface and current is activated with an energy output of 70 Watts. The procedure was carried out in the ambulatory patient in a one-day clinical setting.
S Gordts
Lecture
4 years ago
1083 views
32 likes
0 comments
30:53
The indications of transvaginal endoscopy for diagnosis and treatment of infertility
Standard laparoscopy is frequently postponed and omitted in the exploration of the infertile patient. It is a rather invasive and not innocuous procedure. However, direct endoscopic visualization of the pelvis and the uterine cavity is still considered the gold standard and it is preferred over indirect imaging techniques.
The transvaginal single access approach offers the opportunity to explore the uterus and tubo-ovarian organs in an ambulatory “one-stop fertility” clinical setting. Only direct visualization of the pelvis allows for an accurate diagnosis of minimal endometriosis, tubo-ovarian adhesions, sequellae of PID. When indicated, the procedure was completed with a patency test, salpingoscopy and hysteroscopy. In patients without obvious pelvic pathology, transvafinal endoscopy (TVE) can be used as a first-line diagnostic procedure without postponing an early diagnosis and accurate therapy.
Because of the easy access to the fossa ovarica, the preferred implantation site of endometriosis, limited surgical procedures such as adhesiolysis become possible, the same goes for the treatment of ovarian endometrioma, and ovarian drilling. It allows for an accurate and meticulous dissection of peri-ovarian adhesions and hydroflotation is very helpful in the identification of the exact cleavage plane between the different organs. Small scissors, forceps, and a bipolar coagulation probe are used. A meticulous hemostasis is mandatory, as bleeding will disturb visualization in a watery medium. In case of endometriosis, after the endometrioma has been opened, the chocolate fluid is removed and the inner site of the cyst is superfluously rinsed. The bipolar probe is used to fulgurate the inner endometrial layering.
To drill the ovarian capsule, we use a 5 French bipolar needle (Karl Storz, Tuttlingen, Germany). On each ovary, 5 to 10 punctures were created preferentially at the antero-lateral side of the ovary. The 5 French bipolar needle is gently pushed against the ovarian surface and current is activated with an energy output of 70 Watts. The procedure was carried out in the ambulatory patient in a one-day clinical setting.
Laparoscopic management of pelvic floor relaxation
In this key lecture, Professor JB Dubuisson discusses the indications, technique and results of surgical alternatives to sacrocolpopexy (namely the gold standard technique for POP surgery): laparoscopic lateral suspension with mesh (TiLOOP® mesh used) to treat cystocele and hysterocele or vaginal vault prolapse, (underlining the importance to associate, in these cases, a posterior compartment laparoscopic or vaginal procedure to avoid secondary rectocele); laparoscopic paravaginal repair for site-specific repair (cystocele/lateral cystocele), and finally, laparoscopic spinofixation for site-specific repair of isolated vaginal vault descent or post-prolapse treatment. Of note, a short consideration about titanized polypropylene meshes is made.
JB Dubuisson
Lecture
4 years ago
1177 views
32 likes
0 comments
22:01
Laparoscopic management of pelvic floor relaxation
In this key lecture, Professor JB Dubuisson discusses the indications, technique and results of surgical alternatives to sacrocolpopexy (namely the gold standard technique for POP surgery): laparoscopic lateral suspension with mesh (TiLOOP® mesh used) to treat cystocele and hysterocele or vaginal vault prolapse, (underlining the importance to associate, in these cases, a posterior compartment laparoscopic or vaginal procedure to avoid secondary rectocele); laparoscopic paravaginal repair for site-specific repair (cystocele/lateral cystocele), and finally, laparoscopic spinofixation for site-specific repair of isolated vaginal vault descent or post-prolapse treatment. Of note, a short consideration about titanized polypropylene meshes is made.