Presentation is loading. Please wait.

Presentation is loading. Please wait.

Volume 65, Issue 1, Pages (January 2014)

Similar presentations


Presentation on theme: "Volume 65, Issue 1, Pages (January 2014)"— Presentation transcript:

1 Volume 65, Issue 1, Pages 138-145 (January 2014)
Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse: Surgical Technique and Outcomes at a Single High-volume Institution  Achilles Ploumidis, Anne-Françoise Spinoit, Geert De Naeyer, Peter Schatteman, Melanie Gan, Vincenzo Ficarra, Alessandro Volpe, Alexandre Mottrie  European Urology  Volume 65, Issue 1, Pages (January 2014) DOI: /j.eururo Copyright © 2013 European Association of Urology Terms and Conditions

2 Fig. 1 (a) Preshaped, collagen-coated polypropylene meshes: the anterior mesh is a rectangular strip, the posterior mesh is Y-shaped. (b) Port placement: camera port (purple arrow), robotic ports (red arrows) and port for the assistant (blue arrow). (c) A stay suture retracts the uterus upwards, enabling access to the Douglas space. (d) Dissection of the tissue overlying the sacral periostium. The fourth arm retracts the sigmoid colon laterally. A = anterior mesh; P = posterior mesh; U = uterus; I = right common iliac artery. European Urology  , DOI: ( /j.eururo ) Copyright © 2013 European Association of Urology Terms and Conditions

3 Fig. 2 (a) Creation of a tunnel underneath the right parietal peritoneum of the small pelvis. (b) The rectum is freed from the posterior vaginal wall. The levator fascia can be seen laterally on both sides of the rectum. (c) After suture of the two distal limbs of the posterior mesh to the levator fascia on both sides, a single superficial stitch is placed to fix the middle portion of the mesh on the distal point of the posterior vaginal wall. (d) The anterior vaginal wall is freed from the bladder. R = rectum; VP = posterior vaginal wall; VA = anterior vaginal wall; B = bladder. European Urology  , DOI: ( /j.eururo ) Copyright © 2013 European Association of Urology Terms and Conditions

4 Fig. 3 (a) The anterior mesh is sutured in a continuous, interlocking fashion on the anterior vaginal wall. (b) Both meshes are passed in the tunnel under the parietal peritoneum, while a manual valve repositions the vagina anatomically. (c) Both meshes are sutured to the sacral periostium with a deep stitch. (d) The parietal peritoneum is closed in a running fashion to avoid contact of the meshes with the bowel. A = anterior mesh; B = bladder; M = manual valve; S = sacrum. European Urology  , DOI: ( /j.eururo ) Copyright © 2013 European Association of Urology Terms and Conditions


Download ppt "Volume 65, Issue 1, Pages (January 2014)"

Similar presentations


Ads by Google