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| Name | LAPAROSCOPIC SACROCOLPOPEXY for Vaginal Vault Prolapse - ATUL MISHRA |
| Video Uploader | Video From Dr. Atul Mishra |
| Upload Date | This Video Uploaded At 27-09-2018 18:31:33 |
| Video Discription | VAGINAL VAULT PROLPASE : LAPAROSCOPIC SACROCOLPOPEXY Sacrocolpopexy is a surgical technique to repair pelvic organ prolapse ( specifically apical or vaginal vault prolapse) by suspending apical portion of vagina (vault) using a mesh to sacral promontory. Indications Symptoms of vaginal vault prolapse: Vaginal bulge Pelvic pressure Bleeding Infection Need to manually reduce prolapse to void or defecate Back pain Urinary incontinence, frequency, urgency Anorectal dysfunction: incontinence, urgency, straining to defecate, constipation, incomplete evacuation Technique Position: low lithotomy and steep trendelenburg Ports: 1. At umbilicus (10mm) for telescope 2. Right side slightly below & 6-8cm lateral to umbilicus(10mm) for introduction of needle and mesh 3. Left side mirroring the 2nd port 4. Right side 5cm superior and medial to ASIS (5mm) 5. Optional on left side mirroring the 4th port Steps: The peritoneal reflection over the bladder is incised with scissor. Using sharp dissection urinary bladder is dissected away from anterior vaginal wall along the vesicovaginal septum. Dissection is continued posteriorly to separate the vagina from rectum along the rectovaginal septum. An instrument can be placed in the vagina, such as anastomotic sizer, dilator or ring forceps to identify the proximal extent of the apical vault and facilitate dissection. The retroperitoneal space is then exposed by incising the posterior peritoneum from the level of the rectovaginal septum to the sacral promontory. A Y shaped graft is fashioned using two pieces of polypropylene mesh. The anterior arm is fixed to anterior vaginal cuff using 2-0 prolene. The posterior arm is attached similarly to posterior vaginal wall. The graft is fixed to the anterior longitudinal ligament close to sacral promontory. Peritoneum is closed over mesh. Benefits of Laparoscopic Sacrocolpopexy Less risk of damage to surrounding organs such as bladder or bowel. Less pain, less postoperative complications, quick recovery, shorter hospital stay, more cosmetic scar and better quality of life after surgery. About the Author Dr. Atul Mishra is currently working as Professor of General Surgery and Unit Head at DMC& H, Ludhiana. Dr. Mishra is skilled in all types of complicated and advanced open abdominal and laparoscopic surgeries. He is expert in laparoscopic hernia surgery, Gall bladder stone surgery, Appendectomy, Splenectomy, Rectal prolapse repair, surgery of pancreas, liver, stomach, colon and rectum. He has immense experience in operating complex fistula in ano, pilonidal sinus (limberg flap), parotid thyroid and parathyroid surgery. For more info visit us at http://dratulmishraclinic.com/The-enh.. |
| Category | Education |
| Tags | Laparoscopic Sacrocolpopexy | Vaginal Vault Prolapse | Keyhole surgery for vagina | Atul Mishra | Cystocele | Rectocele | Enterocele |
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