Document Detail

Laparoscopy-like operative vaginoscopy: a new approach to manage mesh erosions.
MedLine Citation:
PMID:  25218994     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Mesh erosion through the vagina is the most common complication of synthetic mesh used for pelvic organ prolapse repair. However, conventional transvaginal mesh excision has many technical limitations. We aimed at creating and describing a new surgical technique for transvaginal removal of exposed mesh that would enable better exposition and access, thus facilitating optimal treatment.
DESIGN: Step-by-step video demonstrating the technique.
SETTING: University tertiary care hospital.
PATIENTS: Five patients previously submitted to pelvic organ prolapse repair using synthetic mesh, presenting mesh erosion through the vagina.
INTERVENTION: Mesh excision using a laparoscopy-like operative vaginoscopy, in which standard laparoscopic instruments are used through a single-incision laparoscopic surgery port device placed in the vagina.
MEASUREMENTS AND MAIN RESULTS: In all cases, a very good exposure of the mesh was achieved, a minimal tissue traction was required, and the procedures were performed in a very ergonomic way. All the patients were discharged in the same day of the surgery, and had a painless postoperative course. So far there have not been cases of relapse of the complaints.
CONCLUSION: This seems to be a simple, cheap and valuable minimally invasive technique, with many advantages in comparison with the conventional approach. More cases and time are necessary to access its long-term efficacy. It may possibly be used for the management of other conditions.
Valentina Billone; Célia Amorim-Costa; Sara Campos; Benoit Rabischong; Nicolas Bourdel; Michel Canis; Revaz Botchorishvili
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-10
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  -     ISSN:  1553-4669     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-14     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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