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| Name | laparoscopic approach to genital prolapse |
| Video Uploader | Video From Dr Ceyhan Baran |
| Upload Date | This Video Uploaded At 14-05-2011 07:49:52 |
| Video Discription | 42 years old G5 P5 BMI 25 patient admitted to gynecology clinic with compliant of protruding mass from the vagina. She got a diagnosis of grade 3 genitourinary prolapse and she was offered to have operation. A lithotomy position was given to the patient. In addition to the 10mm umbilical optik trocar, three 5 mm ancillary trocars (left lower and upper quadrant, right lower quadrant) were inserted. Operation was started with promontory preparation. Posterior peritoneum on promontory was incised, anterior surface of promontory was carefully dissected free to expose pearly white surface of anterior longitudinal ligament. Peritoneal incision was continued down to the anterior rectal region. Then uterus was suspended to abdominal wall for taking advantage of exposure. Peritoneum of douglas was incised, rectovaginal dissection was performed. Elevator Ani muscles were exposed on both sides of the rectum by blunt dissection. Posterior prosthesis (polypropylene) was inserted into abdomen via optic trocar. Prosthetic material was attached with a suture (polyfilament polyester) onto the right and left elevator ani muscles. When the two ends have been firmly anchored to the elevator ani muscles, the midpoint of te curved portion of the mesh was anchored on the vagina. This was done to prevent intestinal loops from coming between the curved porsion of the mesh and the vagina. A window was opened on the posterior leaf of the right broad ligament. Then vesicovaginal dissection was performed. Anterior mesh was inserted into abdomen via optic trocar. Anterior mesh was anchored to the anterior vaginal wall with four sutures, and then anterior mesh was taken to the back through the window on right broad ligament. Posterior and anterior meshes were anchored to the promontory altogether with appropriate tension. Excess meshes were trimmed and after peritonization operation was finished. Patient was discharged on day 3 postoperatively. |
| Category | Science & Technology |
| Tags | ceyhan | baran | laparoscopic | laparoscopy | genital | prolapse |
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