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Laparoscopic Excision of Sacrocolpopexy Mesh.
MedLine Citation:
PMID:  25051537     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To demonstrate surgical maneuvers to facilitate the laparoscopic excision of sacrocolpopexy mesh and prevent potential complications.
DESIGN: Step by step illustration of various surgical techniques using a video compiled from 3 laparoscopic sacrocolpopexy mesh excision procedures done at Magee-Womens Hospital for different indications.
SETTING: Mesh complications such as infection and erosion are frequently managed conservatively but oftentimes necessitate mesh excision for symptom relief. Laparoscopic excision of sacrocolpopexy mesh procedures are typically challenging even in the hands of experienced surgeons. Synthetic mesh, being a foreign body, activates an inflammatory process leading to surrounding tissue fibrosis and scar tissue formation which can distort pelvic anatomy, thereby putting vital organs at risk of injury. Such organs include the bladder, rectum and vagina caudally, the left common iliac vein and middle sacral vessels cephalad and the ureters at the level of the vaginal cuff angles.
INTERVENTION: Laparoscopic excision of sacrocolpopexy mesh.
CONCLUSION: When planning a laparoscopic sacrocolpopexy mesh excision, complications can be avoided with proper surgical technique. It is important to identify vital structures as they may be displaced due to tissue fibrosis. When developing various surgical planes, surgeons should first operate in areas that are adhesion free. This will enhance exposure when dissecting the mesh in proximity of scarred tissue and vital organs. The use of vaginal and rectal probes helps delineate the vesicovaginal and rectovaginal spaces to avoid bladder and bowel injury.
Authors:
Dina Chamsy; Ted Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-19
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  -     ISSN:  1553-4669     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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